Stent-assisted Coiling Of Intracranial Aneurysms Research Articles

Safety and Efficacy of LVIS Jr Stent-assisted Coiling of Intracranial Aneurysms in Small-diameter Parent Arteries : ASingle-center Experience.

To investigate the safety and efficacy of LVIS Jr stent-assisted coiling (SAC) of intracranial aneurysms (IAs) in small-diameter parent arteries and determine the factors influencing incomplete aneurysm occlusion. Clinical and imaging data of 130 patients with IAs in small-diameter parent arteries that were treated with LVIS Jr SAC were retrospectively analyzed. Stent apposition was evaluated by high-resolution flat detector CT, and aneurysm embolization density was evaluated using 2D-DSA. Perioperative complications were recorded. Multivariate logistic regression analyses were performed to determine possible factors for incomplete aneurysm occlusion. In this study, 130 patients (60and 70patients with ruptured and unruptured aneurysms, respectively) were successfully treated with LVIS Jr SAC. Immediate digital subtraction angiography (DSA) showed that the aneurysm occlusion was Raymond-Roy classI, II, IIIa, and IIIb in 93(71.5%), 24(18.5%), 8(6.2%), and 5(3.8%) cases, respectively. There were three cases of acute in-stent thrombosis and two cases of severe vasospasm observed during the perioperative period. The 6‑month follow-up angiograms indicated that complete aneurysm occlusion in 122 patients was 79.5% (97/122). Multivariate logistic regression analyses showed that an aneurysm size > 10.0 mm, parent artery mean diameter < 2.0 mm, and incomplete stent apposition at the aneurysm neck were possible risk factors for incomplete aneurysm occlusion. The LVIS Jr SAC is effective for managing IAs in small-diameter parent arteries. An aneurysm size > 10.0 mm, parent artery mean diameter < 2.0 mm, and incomplete stent apposition at the aneurysm neck are possible risk factors for incomplete aneurysm occlusion.

Initial and mid-term results of LEO Baby stent-assisted coiling of intracranial aneurysms located in small arteries: A single-center experience with 131 consecutive patients.

Background and purposeLow-profile intracranial stents such as the LEO Baby stents are considered to be advantageous for the treatment of intracranial aneurysms originating from small arteries. This study aimed to evaluate the initial and mid-term clinical and angiographic results of LEO Baby stents in stent-assisted coiling of intracranial aneurysms with small parent arteries (<2.5 mm).MethodsWe performed a retrospective study to identify 131 patients with aneurysms arising from small parent arteries treated with Leo Baby stent-assisted coiling in a single institution between October 2018 and June 2021. We assessed the immediate and progressive aneurysm occlusion rates, procedure-related complications, and clinical outcomes.ResultsA total of 131 patients with 135 aneurysms were identified, including 65 (48.1%) cases of acutely ruptured aneurysms. Technical success was achieved in all cases (100%). The immediate angiography showed complete occlusion in 111 aneurysms (82.2%), neck remnants in 19 (14.1%), and residual sac in 5 (3.7%). Procedure-related complications occurred in 14 cases (10.3%), including 13 (9.6%) thromboembolic complications and 1 (0.7%) hemorrhagic complication. Six-month follow-up angiography was achieved in 106 (78.5%) aneurysms, which showed complete occlusion in 102 (96.2%) aneurysms, neck remnants in 2 (1.9%), and residual sac in 2 (1.9%). Clinical follow-up was available in all patients with a median duration of 6.8 months, and favorable clinical outcomes (modified Rankin Scale score: 0–2) reached 91.6%. The mortality rate was 4.6%.ConclusionOur results demonstrate that stent-assisted coiling of intracranial aneurysms located on small arteries using LEO Baby stents is technically feasible, highly effective, and has midterm durability in aneurysmal occlusion.

Correlation Between Vascular Geometry Changes and Long-Term Outcomes After Enterprise Stent Deployment for Intracranial Aneurysms Located on Small Arteries

Enterprise stents are widely used for intracranial aneurysms located on small arteries (<2.5 mm in diameter) and change the geometry of parent arteries. The purpose of this study was to investigate the correlation between vascular geometry changes and long-term outcomes. Between May 2013 and 2018, 1065 consecutive intracranial aneurysms were treated with Enterprise stents at our institution. After inclusion and exclusion criteria were applied, 377 aneurysms with >6 months of digital subtraction angiography follow-up were evaluated. The cohort comprised 101 aneurysms located on small parent arteries. After stent-assisted coiling, the vascular geometry parameters of small parent arteries were compared to explore their correlation with procedural complications, delayed stent migration, and recanalization. The rate of delayed aneurysm occlusion in patients with initial efferent artery diameter (De) <2.5 mm was significantly higher than in patients with De >2.5 mm (62.2% vs. 40.2%; P= 0.032). At follow-up, vascular geometry parameters significantly increased (P < 0.001). In multivariate analyses, larger aneurysms and initial parent artery angle (α) <90° were independent predictors of procedural complications and discrepancy in vessel size (ΔD) >0.5 mm was an independent predictor of delayed stent migration. Larger aneurysms and follow-up angle change (ΔAngle) <30° were independent predictors for recanalization of aneurysms located on small arteries. Enterprise stent-assisted coiling of intracranial aneurysms located on small arteries is safe and effective. Our study found that Enterprise deployment in small arteries had a low procedural complication rate and high stent tolerance. Vascular geometry changes play an important role in aneurysm recanalization.

Clinical and Angiographic Outcomes After Stent-Assisted Coiling of Cerebral Aneurysms With Laser-Cut and Braided Stents: A Comparative Analysis of the Literatures.

Introduction: Stent-assisted coiling (SAC) plays an important role in endovascular treatment of intracranial aneurysms (IAs). This comparative analysis examines the safety and efficacy of SAC in general and compares clinical and angiographic outcomes between laser-cut stents and braided stents.Methods: Relevant English-language studies were identified via a PubMed search for published articles regarding outcomes of SAC using laser-cut stents and braided stents published from 2015 to 2020. Data from 56 studies that met our inclusion criteria were pooled and statistically compared.Results: A total of 4,373 patients harboring with 4,540 IAs were included. Patients were divided into two groups on the basis of stent type: laser-cut stents (2,076 aneurysms in 1991 patients; mean follow-up, 12.99 months) and braided stents (2,464 aneurysms in 2382 patients; mean follow-up, 18.41 months). Overall, the rates of successful stent deployment, thromboembolic events, stent stenosis, periprocedural intracranial hemorrhage, permanent morbidity, mortality, and recanalization were 97.72, 4.72, 2.87, 1.51, 2.14, 1.16, and 6.06%, respectively. Laser-cut stents were associated with a significantly higher rate of successful deployment (p = 0.003) and significantly lower rate of periprocedural intracranial hemorrhage (p = 0.048). Braided stents were associated with a significantly lower rate of permanent morbidity (p = 0.015).Conclusion: SAC of IAs using laser-cut stents or braided stents was effective and safe. Rates of thromboembolic events, stent stenosis, mortality, and recanalization were comparable between the stent types. Braided stents were associated with lower permanent morbidity while laser-cut stents were associated with more favorable rates of successful deployment and periprocedural intracranial hemorrhage.

Follow-up outcomes of intracranial aneurysms treated using braided or laser-cut stents with closed-cell design: a propensity score-matched case-controlled comparison

BackgroundThe impact of various stents on patients with intracranial aneurysms who undergo stent-assisted coiling has been debated. We conducted this study to compare follow-up outcomes of coiling procedures involving braided...

Periprocedural Safety and Feasibility of the New LVIS EVO Device for Stent-Assisted Coiling of Intracranial Aneurysms: An Observational Multicenter Study

<h3>BACKGROUND AND PURPOSE:</h3> Stent-assisted treatment techniques can be an effective treatment option for intracranial aneurysms. The aim of this study was to evaluate the periprocedural feasibility and safety of the new LVIS EVO stent for the treatment of intracranial aneurysms. <h3>MATERIALS AND METHODS:</h3> Patients with intracranial aneurysms treated with the LVIS EVO in 11 European neurovascular centers were retrospectively reviewed. Patient and aneurysm characteristics, procedural parameters, immediate grade of occlusion, and technical and clinical complications were assessed. <h3>RESULTS:</h3> Fifty-seven patients with 59 aneurysms were treated with the LVIS EVO device; 57.6% of the aneurysms were incidental; 15.3% were acutely ruptured; 15.3% were recanalized or residual aneurysms; and 11.9% were treated for symptoms other than acute hemorrhage. The most frequent aneurysm locations were the middle cerebral artery (25.4%) and the anterior communicating artery (22.0%). The rate of immediate successful deployment was 93.2%. In 6.8% (<i>n</i> = 4) of cases, additional in-stent angioplasty was needed. The immediate complete occlusion rate was 54.2%, while there was a residual aneurysm in 35.6% and a residual neck in 10.2%. Periprocedural technical complications occurred in 7/59 treatments (11.9%; the most frequent technical complication [<i>n</i> = 3] was thrombus formation), which all resolved completely without clinical sequelae. Postprocedural neurologic complications occurred after 4/59 treatments (6.8%; 2 transient ischemic attacks, 1 minor stroke, 1 major stroke), of which only 1 persistent complication was directly related to the procedure (minor stroke in the vascular territory distal to the stent). <h3>CONCLUSIONS:</h3> The LVIS EVO stent is a safe, feasible device for the treatment of intracranial aneurysms.

Transcirculation approach for stent-assisted coiling of intracranial aneurysms: a multicenter study

BackgroundThe transcirculation approach (TCA) for stent-assisted coiling (SAC) of intracranial aneurysms may be useful for certain wide-neck bifurcation aneurysms as well as those with acute-angle efferent branches.ObjectiveTo describe a multicenter...

Double porous media modeling in computational fluid dynamics for hemodynamics of stent-assisted coiling of intracranial aneurysms: A technical case report

Endovascular therapy is developing, but not all aneurysms are completely obliterated even by using the techniques such as stent-assisted coiling or a flow diverter. To predict the aneurysm-occlusion status after stent-assisted coiling, the authors applied computational fluid dynamics (CFD) using porous media modeling to propose a new technique with the double porous media settings, one of which is a porous media setting for a coiled aneurysm and another of which is that for an intracranial stent. CFD with double porous media settings using preoperative aneurysm geometry may be useful for simulating the hemodynamic changes in intracranial aneurysms after stent-assisted coiling.

Low-Profile Laser-Cut Stents for Endovascular Treatment of Intracranial Aneurysms : Incidence, Clinical Presentation and Risk Factors of Thromboembolic Events.

Low-profile intracranial stents are characterized by aminiaturized design that enables deployment via a0.0165″ or 0.017″ internal diameter microcatheter, which is typically intended for coil delivery. This study analyzed the incidence, clinical relevance and risk factors of thromboembolic events (TEE) occurring during low-profile stent-assisted coiling of intracranial aneurysms. This was aretrospective, multicenter analysis of consecutive patients who underwent stent-assisted aneurysm coiling (SAC) with the laser-cut Acandis Acclino and Neuroform Atlas stents. The study evaluated the incidence of symptomatic and asymptomatic TEEs and the impact on functional outcome. Risk factors for TEEs were determined by univariate and bivariate logistic regression analyses. Among 131 procedures (mean patient age 56.5 ± 12.8 years, mean aneurysm size: 6.7 ± 3.9 mm) TEEs occurred in 14cases (10.7%) of which 2patients (1.5%) developed ischemic stroke, while the remaining TEEs remained asymptomatic. Multivariate analysis revealed Y‑stenting as potential risk factor for TEEs (odds ratio: 3.9, 95% confidence interval: 1.0-16.5; p = 0.08). The use of SAC with low-profile intracranial stents is associated with afavorable safety profile; however, Y‑stenting may carry an increased risk of TEEs, which needs to be considered during treatment planning.

Visualization of stent apposition after stent-assisted coiling of intracranial aneurysms using high resolution 3D fusion images acquired by C-arm CT

PurposeWe used an imaging technique based on 3-dimensional (3D) C-arm CT to assess the apposition of three types of stents after coiling of intracranial aneurysms.MethodsAll patients with intracranial aneurysms were...

Long-term Angiographic Results of the Low-profile Acandis Acclino Stent for Treatment of Intracranial Aneurysms : AMulticenter Study.

The low-profile Acandis Acclino is aself-expandable nitinol microstent for stent-assisted coiling of intracranial aneurysms. This article reports long-term clinical and angiographic outcome in amulticenter setting. In this study 98 consecutive patients (mean age 55.4 ± 13.5 years) were treated with the Acclino for 98aneurysms (28unruptured, 20recurrent, 50ruptured) at 3 German tertiary care centers within a6-year period. The technical success, complications, clinical outcome and angiographic results were retrospectively analyzed. The technical success rate was 100% with immediate complete occlusion achieved in 89.8% of the patients. Among 65patients (66.3%) available for a 6‑month follow-up, complete and near-complete occlusion rates were 92.3% and 98.5%, respectively. In 38patients (38.8%) with long-term follow-up (mean: 21months), complete and near-complete occlusion were achieved in 81.2% and 89.5%, respectively. Aneurysm recurrence between mid-term and long-term follow-up was observed in 14.3%. The retreatment rate was 11.3%. There were three thromboembolic events (3.1%), of which one resulted in ischemic stroke (1.0%). For unruptured aneurysms, the procedural and device-related morbidity rates were 2.1% and 0%, respectively. In the present study, the Acclino was associated with alow risk of thromboembolic complications and high aneurysm occlusion rates at long-term follow-up. Due to incomplete angiographic follow-up in this series, prospective studies will be necessary to confirm the results.

Preliminary Experience of Lvis Blue in the Internal Carotid Artery for The Treatment Of Wide-Necked Intracranial Aneurysms

Objective A new Low-profile Visualized Intraluminal Support device (LVIS Blue) is a braided stent that provides a higher degree of metal coverage and increasingly used for the stent-assisted coiling of intracranial aneurysms. In the present study, our preliminary experience of using LVIS Blue in the internal carotid artery (ICA) for the treatment of wide-necked intracranial aneurysms was reported. Methods This retrospective review included patients with ICA aneurysms prospectively collected from our database who were treated using LVIS Blue at our institution from September 2017 to December 2018. Angiographic results, clinical outcomes, and technical issues were evaluated. Results A total of 22 patients with unruptured wide-necked ICA aneurysms were treated using LVIS Blue. Seven aneurysms were located in the superior hypophyseal artery, 4 in posterior communicating artery, 4 in ICA dorsal wall, 3 in ICA bifurcation, 2 in ophthalmic artery, 1 in ICA ventral wall, and 1 in ICA lateral wall. During the procedure, suboptimal positioning and foreshortening of the stent occurred in 1 patient each. Immediate postembolization angiography showed complete obliteration in 13 patients (59.1%), residual neck in 4 (18.2%), and residual aneurysm in 5 patients (22.7%). Follow-up angiographic results showed complete obliteration in 19 patients (86.4%). In-stent stenosis (> 50% stenosis) was not observed on follow-up angiography. In addition, morbidity or mortality did not occur. Conclusion The LVIS Blue may be feasible and safe for stent-assisted coiling in ICA aneurysms. Foreshortening, suboptimal deployment, and difficulty to open proximal ends may be considerable technical issues in the tortuous ICA. Keywords: Intracranial aneurysm; Wide-necked aneurysm; LVIS Blue; Stent-assisted coiling.

Safety and efficacy of the Neuroform Atlas for stent-assisted coiling of intracranial aneurysms: A multicenter experience

ObjectiveClinical data on the new Neuroform Atlas stent for treatment of intracranial aneurysms is limited. We report our experience in stent-assisted coiling procedures of complex, predominantly wide-necked aneurysms. MethodsThis is a retrospective study of consecutive patients treated with the Neuroform Atlas stent between August 2014 and November 2018 at three German tertiary care centers. We evaluated the complication rate, clinical outcome and angiographic result at mid-term follow-up. ResultsThirty-seven aneurysms (elective: 23, previous subarachnoid hemorrhage: 14) were treated in 37 patients (mean age: 59.4 years, 62.2% females). Stent-assisted coiling was successful in all cases, achieving immediate complete aneurysm occlusion by coiling in 83.8% and neck remnants in 16.2%. At 6-month angiographic follow-up, complete aneurysm occlusion was obtained in 80.8% (21/26), neck remnants in 11.5% (3/26) and aneurysm remnants in 7.7% (2/26). Retreatment was necessary in 7.7%. Ischemic stroke occurred in one patient (2.7%). At 6-month clinical follow-up, procedure-related permanent morbidity was 2.7%. ConclusionsOur results demonstrate that treatment of intracranial aneurysms with the Neuroform Atlas stent is associated with low morbidity and a high aneurysm occlusion rate at mid-term follow-up. Further studies will be necessary to confirm our results.

Accuracy of Length of Virtual Stents in Treatment of Intracranial Wide-Necked Aneurysms

Background and PurposePrecise stent deployment is important for successful treatment of intracranial aneurysms by stent-assisted coiling (SAC). We evaluated the accuracy of virtual stents generated using commercial stent planning software by comparing the length of virtual and actually deployed intracranial laser cut stents on three-dimensional digital subtraction angiography (3D-DSA) images.MethodsWe retrospectively analyzed the data of 75 consecutive cases of intracranial wide-necked aneurysms treated with the SAC technique using laser cut stents. Based on 3D-DSA images acquired by C-arm CT, stent sizing and placement were intraoperatively simulated by a commercial software application. The difference in length of the stents was estimated by measuring proximal discrepancies between the end points of the virtual and actually deployed stents on fused pre-procedural and post-procedural 3D-DSA images. Discrepancies between distal stent end points were manually minimized. The Kruskal–Wallis test was applied to test whether stent location, type, and length had an effect on difference in length between virtual and real stent.ResultsThe median difference in length between virtual and real stents was 1.58 mm with interquartile range 1.12–2.12 mm. There was no evidence for an effect of stent location (p = 0.23), stent type (p = 0.33), or stent length (p = 0.53) on difference in length between virtual and real stents.ConclusionsStent planning software allows 3D simulation of laser cut stents overlain on 3D-DSA images of vessels and may thus be useful for stent selection and deployment of laser cut stents during stent-assisted coiling of intracranial aneurysms.

Abstract WP119: Stent-Assisted Coiling of Intracranial Aneurysms With the Neuroform ATLAS Stent: Immediate and Midterm Angiographic and Clinical Follow-Up

Object: Self-expandable stents have broadened the spectrum of endovascular treatment of intracranial aneurysms. The Neuroform ATLAS, the evolution of Neuroform EZ, is a nitinol self-expanding hybrid/open-cell stent, which can be delivered through a low-profile 0.017 inch catheter. We present our experience in the treatment of intracranial aneurysms with this stent. Methods: We prospectively maintained a database from consecutive patients who underwent stent-assisted coiling with Neuroform ATLAS from July 2015 to July 2018. Clinical and angiographic results were analyzed. Results: Ninety-one patients harboring 95 aneurysms were treated in 95 procedures. A single stent was used in 42 (44.2%) cases, while 52 (54.7%) aneurysms were treated with 2 stents (50 “Y” configuration, 2 “X” configuration). One case of Y stent-assisted coiling was prematurely interrupted because of aneurysm perforation. Post-treatment control angiography showed complete occlusion in 55 cases (58.5%), neck remnant in 15 cases (15.9%), incomplete occlusion in 24 cases (25.5%). The overall symptomatic peri-procedural complication rate was 13.7%. The overall morbidity rate was 4.2% (4 cases with a modified Rankin Scale &gt;2 and &lt;6). The overall mortality rate was 2.1% (2 cases). Fifty-six aneurysms underwent follow-up (mean follow-up: 10.5 months): 47 aneurysms (83.9%) were completely occluded, 7 aneurysms (12.5%) had a neck remnant, and 2 aneurysms (3.6%) was incompletely occluded. Conclusion: The Neuroform ATLAS is an effective device for treatment of complex intracranial aneurysms, allowing good conformability and high level of navigability, but with a non-negligible rate of complications.

Intracranial Complex Ruptured Aneurysms Coiled with Overlapping Low-Profile Visualized Intraluminal Support Stents: Another Available Option for Complex Ruptured Intracranial Aneurysms

Overlapping stents represent a new paradigm in endovascular interventions, especially for complex and wide-necked aneurysms. The low-profile visualized intraluminal support (LVIS) device is a new generation of self-expanding braided stents recently introduced in China for stent-assisted coiling of intracranial aneurysms. We report several cases of intracranial aneurysms coiled using overlapping LVIS stents to evaluate its efficacy and safety. Patients with ruptured intracranial aneurysms treated with double LVIS stents at our center between November 2014 and May 2016 were reviewed. The clinical data and technical results are presented. Ten patients with 15 aneurysms were treated with double LVIS stents, with a 100% technical success rate. No mortality was observed. Immediate angiographic outcome evaluation showed complete occlusion in 13 aneurysms (86.7%) and neck remnants in 2 aneurysms (13.3%). Double LVIS stents are safe and effective in the treatment of intracranial aneurysms, especially complex aneurysms.

Symptomatic periprocedural intracranial hemorrhage unrelated to coil embolization in 1287 patients with intracranial aneurysms.

Periprocedural symptomatic intracranial hemorrhage (sICH) unrelated to coil embolization of intracranial aneurysm has been rarely reported. The incidence and characteristics of this complication remain unclear. This study was designed to elucidate the incidence and characteristics of periprocedural sICH unrelated to coiling of intracranial aneurysm, and to explore the possible mechanisms underlying this complication. Included in this retrospective study were 1287 patients with 1394 aneurysms who were treated with coil embolization (476 patients with stent assistance and 811 patients without stents) between May 2008 and August 2017. All procedure-unrelated sICHs that occurred within 30days after coiling were selected. The technical details of the procedure, clinical characteristics, and medical therapy were recorded. A total of 6 patients developed periprocedural sICH unrelated to coil embolization. All these six patients underwent stent-assisted coiling (SAC). Therefore, there was a 1.3% (6/476) procedure-unrelated sICH rate of SAC and 0% (0/811) in patients underwent coiling without stent during the periprocedural period (P = 0.005, RR 0.987; 95% CI, 0.977-0.997). These phenomena occurred more often in patients who received SAC for ruptured aneurysms vs patients underwent this technique for unruptured aneurysms (2.0 vs 0.7%, P = 0.390, RR 2.896; 95% CI, 0.525-15.968). All these phenomena occurred within 7days after coiling, and resulted in one mortality, one unfavorable outcome (mRS Score 3), and other four favorable outcomes (mRS Scores 0-2) at 90days after procedure. Our findings suggest that the procedure-unrelated sICH, though less frequent, may exist following stent-assisted coiling of intracranial aneurysm during the periprocedural period. Extra caution may be warranted in patients who were treated with SAC for ruptured aneurysms.

Long-term outcomes of Low-profile Visualized Intraluminal Support device usage in stent-assisted coiling of intracranial aneurysm

Stent-assisted coil embolization technique have broadened indications for endovascular therapy of aneurysms. The Low-profile Visualized Intraluminal Support device (LVIS) is a self-expanding, nitinol single-braid and closed-cell device introduced fairly recently. We aim to evaluate long-term outcome of LVIS device in stent-assisted coiling of intracranial aneurysms.Between October 2012 and February 2013, a total of 55 patients with unruptured wide-necked intracranial aneurysms underwent coil embolization procedures involving LVIS devices. Clinical and anatomic parameters assessed included extent of aneurysmal occlusion, stent deployment status, and delayed complications. Anatomic outcomes were evaluated via DSA, MRA, and plain radiography (PR).Three patients were lost to follow-up after 6 months, but in 37 of 52 qualifying patients (mean follow-up, 27.1 months; range, 12–36 months) post-coiling recanalization was evaluable by DSA or MRA. Only one patient (2.7%) experienced minor recanalization, all others (97.3%) showing complete occlusion. Coil configurations were consistently stable by PR in 15 other patients (mean follow-up, 34.1 months; range, 30–39 months). No migration or altered expansion of stents was evident in 30 patients with available DSA and/or PR images. Three patients (5.8%) suffered delayed cerebral ischemia without neurologic sequelae, all as transient ischemic attacks and all related to withdrawal or change of anti-platelet medications. LVIS device usage in stent-assisted coil embolization of intracranial aneurysms provides excellent long-term results in terms of safety, efficacy and durability.

Short-term vs Long-term Dual Antiplatelet Therapy for Prevention of Delayed Thromboembolic Events after Stent-Assisted Coiling of Intracranial Aneurysm: A Randomized Clinical Trial

Short-term vs Long-term Dual Antiplatelet Therapy for Prevention of Delayed Thromboembolic Events after Stent-Assisted Coiling of Intracranial Aneurysm: A Randomized Clinical Trial

Stent-assisted coiling of intracranial aneurysms using LEO stents: long-term follow-up in 153 patients.

Coiling associated with placement of a self-expandable intracranial stent has improved the treatment of intracranial wide-necked aneurysms. Little is known, however, about the durability of this treatment. The purpose of this report is to present our experience with the LEO stent and to evaluate the complications, effectiveness, and long-term results of this technique. We analyzed the records of 155 intracranial unruptured aneurysms that were treated by stent-assisted coiling with a LEO stent between 2008 and 2012. Procedural, early post-procedural, and delayed complications were recorded. Clinical and angiographic follow-up of patients was conducted over a period of at least 36months. No procedural mortality was observed. One-month morbidity was observed in 14 out of 153 patients (9,15%). One hundred thirty-eight patients (with 140 aneurysms) had clinical and angiographic follow-up for more than 36months. No aneurysm rupture was observed during follow-up. Four patients presented an intra-stent stenosis at 8months, and 6 patients who had an early recurrence were retreated. Final results showed 85% complete occlusion, 13% neck remnants, and 2% stable incomplete occlusion. Stent-assisted coiling with the LEO stent is a safe and effective treatment for unruptured intracranial aneurysms. The long-term clinical outcomes with the LEO stent are excellent with a high rate of complete occlusion that is stable over time.