Kabbasch C, Liebig T, Faymonville A, Dorn F, Mpotsaris A
Department of Radiology and Neuroradiology, University of Cologne, University Medical Center, Cologne, Germany.
Department of Neurosurgery, University of Cologne, University Medical Center, Cologne, Germany.
J Vasc Interv Neurol. 2015 Jul;8(3):1-6.
The Acclino is a laser-cut closed-cell microstent composed of nitinol. It was developed for stent-assisted coiling of wide-neck intracranial aneurysms. The key feature of the stent is its deployability via low-profile microcatheters with an inner diameter of 0.0165 inch, which are also suited for coil deployment. The objective of this study was to evaluate the safety and feasibility as well as the immediate and mid-term results of this new device.
Our database was screened for all Acclino-based stent-assisted intracranial coil embolizations since its introduction to the European market in June 2012. Case files and imaging data were retrospectively analyzed for angiographical and clinical outcome parameters, including immediate and mid-term modified Raymond-Roy aneurysm occlusion classification (RROC) rates and procedural complications.
Fourteen patients comprising 14 aneurysms (9 unruptured and 5 ruptured) were treated with the Acclino. All except for a dissecting one were wide-neck saccular aneurysms. Immediate complete occlusion (RROC1) was observed in 8/14 cases (57%), a residual neck (RROC2) in 4/14 (29%), and a persistent filling of the dome (RROC 3) in 1/14 cases (7%). An in-stent thrombus formation in one case (7%) was medically resolved without neurological deficit. Follow-up was available in 9/14 cases (64%) after a mean of 137 days (SD ± 50). All followed cases depicted a complete occlusion (RROC1).
The Acclino microstent showed a satisfactory safety profile and a promising rate of immediate and mid-term complete aneurysm occlusion for stent-assisted coil embolization in wide-neck intracranial aneurysms, warranting further investigation of the device.
Acclino是一种由镍钛合金制成的激光切割闭孔微支架。它是为宽颈颅内动脉瘤的支架辅助弹簧圈栓塞术而研发的。该支架的关键特性在于其能够通过内径为0.0165英寸的低轮廓微导管进行展开，这种微导管同样适用于弹簧圈的置入。本研究的目的是评估这一新型装置的安全性、可行性以及即刻和中期效果。
自2012年6月Acclino进入欧洲市场以来，我们在数据库中筛选了所有基于Acclino的支架辅助颅内弹簧圈栓塞术病例。对病例档案和影像数据进行回顾性分析，以获取血管造影和临床结局参数，包括即刻和中期改良雷蒙德 - 罗伊动脉瘤闭塞分级（RROC）率以及手术并发症。
14例患者（共14个动脉瘤，其中9个未破裂，5个破裂）接受了Acclino治疗。除1个夹层动脉瘤外，其余均为宽颈囊状动脉瘤。14例中有8例（57%）实现即刻完全闭塞（RROC1），4例（29%）有残余瘤颈（RROC2），1例（7%）瘤顶持续显影（RROC 3）。1例（7%）出现支架内血栓形成，经药物治疗后血栓溶解，未遗留神经功能缺损。14例中有9例（64%）获得随访，平均随访时间为137天（标准差±50）。所有接受随访的病例均显示完全闭塞（RROC1）。
Acclino微支架在宽颈颅内动脉瘤的支架辅助弹簧圈栓塞术中显示出令人满意的安全性，以及有前景的即刻和中期动脉瘤完全闭塞率，值得对该装置进行进一步研究。
