Neuroradiology Unit, Biomedical Sciences and of Morphologic and Functional Images, AOU Policlinico G. Martino, Messina, Italy.
Neuroradiology Unit, Biomedical Sciences and of Morphologic and Functional Images, AOU Policlinico G. Martino, Messina, Italy.
J Neuroradiol. 2020 Nov;47(6):421-427. doi: 10.1016/j.neurad.2019.03.005. Epub 2019 Apr 2.
Wide-necked brain aneurysms therapy remains a challenge for neurointerventionalists, mainly for the high recurrence rate. Low-profile stents make feasible the treatment of these aneurysms. In our multicenter series we analyzed clinical and angiographic results of Neuroform Atlas stent-assisted coiling.
From January 2016 to March 2017, 113 wide-necked aneurysms were discovered with CTA, MRA and DSA. The Atlas stent-assisted coiling procedures were performed under general anesthesia with sequential or jailing techniques. Six months follow-up DSA was performed to assess the recurrence rate through the modified Raymond-Roy occlusion scale (RROC). Moreover, patients were evaluated clinically to analyse the degree of disability according to the mRS. MRI was performed at 12 months evaluating both the cerebral tissue and the vessels.
In all the procedures it was feasible to navigate the Neuroform Atlas to the goal vessel and deploy the stent across the aneurysmal neck. Intra-procedural complications account for the 6.2% (7/113). The immediate occlusion rate was RROC 1 in 88%, 2 in 9% and 3 in 3% of cases. The 6 months clinical data showed mRS Score 0-1 in 96.5% of patients; 3 patients died of complications related to SAH. The 12 months follow-up showed RROC of 1 in 82%, 2 in 13% and 3 in 5% of cases. No aneurysm has been retreated.
In our multicenter experience the Neuroform Atlas stent assisted-coiling has shown to be a safe and effective technique for the treatment of wide-necked intracranial aneurysms with encouraging clinical and angiographic results.
宽颈颅内动脉瘤的治疗对神经介入医生来说仍然是一个挑战，主要是因为复发率高。低轮廓支架使得治疗这些动脉瘤成为可能。在我们的多中心系列研究中，我们分析了 Neuroform Atlas 支架辅助弹簧圈治疗的临床和血管造影结果。
从 2016 年 1 月至 2017 年 3 月，我们通过 CTA、MRA 和 DSA 发现了 113 个宽颈动脉瘤。在全身麻醉下，采用序贯或监禁技术进行 Atlas 支架辅助弹簧圈治疗。在 6 个月时进行 DSA 随访，通过改良 Raymond-Roy 闭塞分级（RROC）评估复发率。此外，我们还对患者进行了临床评估，根据 mRS 评估残疾程度。在 12 个月时进行 MRI 评估，评估脑组织和血管。
在所有的手术中，都可以将 Neuroform Atlas 导航到目标血管，并将支架跨越动脉瘤颈部放置。术中并发症发生率为 6.2%（7/113）。即时闭塞率为 RROC 1 级 88%，2 级 9%，3 级 3%。6 个月的临床数据显示，96.5%的患者 mRS 评分 0-1；3 例患者死于与蛛网膜下腔出血相关的并发症。12 个月的随访显示，RROC 1 级 82%，2 级 13%，3 级 5%。没有动脉瘤需要再次治疗。
在我们的多中心经验中，Neuroform Atlas 支架辅助弹簧圈治疗宽颈颅内动脉瘤是一种安全有效的技术，具有令人鼓舞的临床和血管造影结果。
