Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Minato-ku, Tokyo, Japan.
Department of Neurosurgery, The Jikei University School of Medicine Tokyo, Minato-ku, Tokyo, Japan.
World Neurosurg. 2021 Feb;146:e701-e707. doi: 10.1016/j.wneu.2020.10.166. Epub 2020 Nov 9.
We report the clinical outcomes of stent-assisted coiling for wide-necked intracranial aneurysms using 3 low-profile laser-cut stents and compare the results according to stent type.
All patients treated with stent-assisted coiling for their intracranial aneurysms at our hospital between July 2010 and September 2019 were reviewed. We selected patients with Enterprise, Neuroform EZ, or Neuroform Atlas stents who underwent imaging follow-up and investigated aneurysm and stent features, stent-related complications, recanalization, and retreatment rates. We compared the retreatment risk among the patients treated with the 3 stent types using Kaplan-Meier survival analysis and Cox regression analysis.
We evaluated 364 consecutive cases (103 Enterprise, 105 Neuroform EZ, and 156 Neuroform Atlas stents). Neuroform Atlas was more frequently used in distal vessels: 8 (7.8%) Enterprise, 2 (1.9%) Neuroform EZ, and 41 (26.3%) Neuroform Atlas cases, respectively. The median follow-up durations were 6.49, 4.91, and 1.24 years for the Enterprise, Neuroform EZ, and Neuroform Atlas cases, respectively, and retreatment was performed in 11 (10.1%), 9 (8.6%), and 6 (3.8%) cases. In the first 2 years of follow-up, the estimated retreatment risk ratios for Neuroform EZ and Neuroform Atlas with Enterprise as reference were 0.63 (95% confidence interval, 0.24-1.65; P = 0.35) and 0.54 (95% confidence interval, 0.18-1.59; P = 0.26), respectively.
Neuroform Atlas stents were more frequently deployed in small-caliber vessels compared with the other 2 types of stents. The complication rate and retreatment risk until at least 1 year after the aneurysm treatment appeared to be similar for the 3 stent types.
我们报告使用 3 种低剖面激光切割支架对宽颈颅内动脉瘤进行支架辅助弹簧圈栓塞的临床结果，并根据支架类型比较结果。
回顾 2010 年 7 月至 2019 年 9 月期间在我院接受支架辅助弹簧圈栓塞治疗的颅内动脉瘤患者。我们选择了使用 Enterprise、Neuroform EZ 或 Neuroform Atlas 支架的患者，这些患者进行了影像学随访，并研究了动脉瘤和支架的特征、支架相关并发症、再通和再治疗率。我们使用 Kaplan-Meier 生存分析和 Cox 回归分析比较了 3 种支架类型的患者的再治疗风险。
我们评估了 364 例连续病例（Enterprise 支架 103 例，Neuroform EZ 支架 105 例，Neuroform Atlas 支架 156 例）。Neuroform Atlas 支架更常应用于远端血管：Enterprise 支架分别为 8 例（7.8%）、Neuroform EZ 支架为 2 例（1.9%）、Neuroform Atlas 支架为 41 例（26.3%）。Enterprise、Neuroform EZ 和 Neuroform Atlas 支架的中位随访时间分别为 6.49、4.91 和 1.24 年，分别有 11（10.1%）、9（8.6%）和 6（3.8%）例患者需要再次治疗。在随访的前 2 年，Neuroform EZ 和 Neuroform Atlas 支架与 Enterprise 支架相比，再治疗风险比分别为 0.63（95%置信区间，0.24-1.65；P=0.35）和 0.54（95%置信区间，0.18-1.59；P=0.26）。
与其他 2 种支架相比，Neuroform Atlas 支架更常应用于小口径血管。至少在动脉瘤治疗后 1 年内，3 种支架类型的并发症发生率和再治疗风险似乎相似。
