支架辅助弹簧圈栓塞治疗颅内动脉瘤：Neuroform Atlas 支架与 EZ 支架的头对头比较。
Stent-assisted coiling of cerebral aneurysms: Head to head comparison between the Neuroform Atlas and EZ stents.
机构信息
Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.
Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
出版信息
Interv Neuroradiol. 2021 Jun;27(3):353-361. doi: 10.1177/1591019921989476. Epub 2021 Jan 28.
BACKGROUND
The Neuroform Atlas stent is thought to have features allowing for an improved stent delivery system. We aimed to provide a comparison of the Atlas and Neuroform EZ stents in patients treated with stent-assisted coiling.
METHODS
Seventy-seven aneurysms treated with the Atlas stent and 77 aneurysms with similar characteristics treated with the EZ stent were retrospectively compared. Outcomes included angiographic occlusion per the Raymond-Roy (RR) scale, recanalization, retreatment and procedural complications.
RESULTS
With the Atlas stent, technical success was 100% and immediate RR1 occlusion was 81.8%. Follow-up RR1 was achieved in 83.7%. The recanalization rate was 7% and the retreatment rate was 4.6%. The complication rate was 6.5% (new neurological deficit in 1.3%). With the EZ stent, technical success was 96%, immediate RR1 occlusion was 67.6% and follow-up RR1 was 67.6%. The recanalization rate was 12.7% and the retreatment rate was 14.1%. The complication rate was 10.4% (new neurological deficit in 2.6%). The rate of immediate RR1 occlusion was significantly higher with the Atlas stent ( = 0.03), and the rate of follow-up RR1 was nonsignificantly higher with the Atlas stent ( = 0.08). The retreatment rate was significantly lower with the Atlas stent ( = 0.009). There were no significant differences in the rates of recanalization ( = 0.5) and complications ( = 0.6).
CONCLUSIONS
Stent-assisted coiling with the Atlas stent is safe and effective and shows better immediate results as compared to the EZ stent, with improved overall follow-up outcomes.
背景
Neuroform Atlas 支架被认为具有改进的支架输送系统的特点。我们旨在比较 Atlas 支架和 Neuroform EZ 支架在接受支架辅助弹簧圈治疗的患者中的应用。
方法
回顾性比较了 77 例使用 Atlas 支架治疗的动脉瘤和 77 例具有相似特征的使用 EZ 支架治疗的动脉瘤。结果包括根据 Raymond-Roy（RR）分级的血管造影闭塞、再通、再治疗和程序并发症。
结果
使用 Atlas 支架，技术成功率为 100%，即刻 RR1 闭塞率为 81.8%。随访时达到 RR1 闭塞率为 83.7%。再通率为 7%，再治疗率为 4.6%。并发症发生率为 6.5%（新的神经功能缺损发生率为 1.3%）。使用 EZ 支架，技术成功率为 96%，即刻 RR1 闭塞率为 67.6%，随访时 RR1 闭塞率为 67.6%。再通率为 12.7%，再治疗率为 14.1%。并发症发生率为 10.4%（新的神经功能缺损发生率为 2.6%）。Atlas 支架即刻 RR1 闭塞率显著高于 EZ 支架（=0.03），而 Atlas 支架随访时 RR1 闭塞率无显著差异（=0.08）。Atlas 支架的再治疗率显著较低（=0.009）。再通率（=0.5）和并发症发生率（=0.6）无显著差异。
结论
与 EZ 支架相比，Atlas 支架辅助弹簧圈治疗安全有效，即刻结果更好，总体随访结果更佳。
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