Stroke Center, Henan Provincial People's Hospital, Zhengzhou University, 7 Weiwu Road, Zhengzhou, Henan, China.
Sci Rep. 2023 Aug 22;13(1):13695. doi: 10.1038/s41598-023-40725-1.
To investigate the effect and safety of the Neuroform Atlas (NFA) stent in stent-assisted coiling of wide-necked intracranial aneurysms, patients with wide-necked intracranial aneurysms were retrospectively enrolled and treated with the NFA stent-assisted coiling. The modified Rankin scale (mRS) grades and Raymond grades were used to assess the clinical outcomes and aneurysm occlusion degrees, respectively, after embolization and at follow-up. Totally, 122 patients were enrolled with 129 wide-necked aneurysms, and forty-nine (40.2%) patients experienced subarachnoid hemorrhage. A total of 134 NFA stents were deployed in all patients. Immediately after endovascular embolization, the Raymond grade was I in 112 (86.8%), II in 8 (6.2%), and III in 9 (7.0%). Complications occurred in 7 (5.7%) patients, including stent displacement in 2 (1.6%) patients, thrombosis and cerebral infarction in 4 (3.3%), and death in 1 (0.8%). Clinical follow-up was performed in 113 (92.6%) patients 6-30 (mean 21) months after embolization, with the mRS grade 0 in 99 (87.6%) patients, 1 in 7 (6.2%), 2 in 5 (4.4%), and 3 in 2 (1.8%). Good prognosis (mRS ≤ 2) was achieved in 111 (98.2%) patients while poor prognosis (mRS > 2) in two (1.8%). Digital subtraction angiography was conducted in 98 (80.3%) patients with 104 (80.6%) aneurysms 6-30 (mean 21) months after embolization. The Raymond grade was grade I in 94 (90.4%) aneurysms, II in 4 (3.8%), and III in 6 (5.8%). Compared with the Raymond grades immediately after embolization, 93 (89.4%) aneurysms disappeared, 9 (8.7%) remained unchanged in the occlusion status, and 2 (1.9%) were recurrent. In conclusion, the NFA stent may have a high aneurysm occlusion rate and a low complication rate in assisting coiling of wide-necked intracranial aneurysms even though further studies are necessary to prove this.
为了研究 Neuroform Atlas（NFA）支架在宽颈颅内动脉瘤支架辅助弹簧圈栓塞中的效果和安全性，回顾性纳入了宽颈颅内动脉瘤患者，并采用 NFA 支架辅助弹簧圈栓塞进行治疗。采用改良 Rankin 量表（mRS）评分和 Raymond 分级分别评估栓塞后和随访时的临床转归和动脉瘤闭塞程度。共有 122 例患者（129 个宽颈动脉瘤）入组，其中 49 例（40.2%）患者发生蛛网膜下腔出血。所有患者共置入 134 枚 NFA 支架。血管内栓塞后即刻，Raymond 分级为Ⅰ级 112 例（86.8%），Ⅱ级 8 例（6.2%），Ⅲ级 9 例（7.0%）。7 例（5.7%）患者发生并发症，包括 2 例（1.6%）支架移位，4 例（3.3%）血栓形成和脑梗死，1 例（0.8%）死亡。栓塞后 6-30 个月（平均 21 个月）对 113 例（92.6%）患者进行临床随访，mRS 评分 0 级 99 例（87.6%），1 级 7 例（6.2%），2 级 5 例（4.4%），3 级 2 例（1.8%）。111 例（98.2%）患者预后良好（mRS≤2），2 例（1.8%）患者预后不良（mRS>2）。栓塞后 98 例（80.3%）患者行数字减影血管造影检查，其中 104 例（80.6%）动脉瘤栓塞后 6-30 个月（平均 21 个月）。Raymond 分级为Ⅰ级 94 例（90.4%），Ⅱ级 4 例（3.8%），Ⅲ级 6 例（5.8%）。与栓塞后即刻的 Raymond 分级相比，93 例（89.4%）动脉瘤完全闭塞，9 例（8.7%）动脉瘤闭塞状态无变化，2 例（1.9%）动脉瘤复发。总之，NFA 支架辅助宽颈颅内动脉瘤弹簧圈栓塞可能具有较高的动脉瘤闭塞率和较低的并发症发生率，但仍需要进一步研究证实。
