Chang Xiaoting, Fei Mingyang, Feng Baozhi, Ren Tong, Shang Wei
Department of Neurology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China.
Department of Neurosurgery, the First Affiliated Hospital of Dalian Medical University, Dalian 116000, Liaoning Province, China.
J Stroke Cerebrovasc Dis. 2025 Jan;34(1):108156. doi: 10.1016/j.jstrokecerebrovasdis.2024.108156. Epub 2024 Nov 26.
To investigate the effectiveness, safety, and efficacy of Atlas stents in the treatment of distal intracranial aneurysms (IAs).
We retrospectively analyzed patients with IAs who underwent stent-assisted coiling (SAC) from January 2018 to January 2022 and divided them into two groups: distal IAs treated with Atlas SAC and wide-necked aneurysms in other locations treated with SAC. The clinical data, imaging data, and postoperative follow-up data for the two groups of patients during hospitalization were collected.
Fifteen patients were included in the distal IA group, and 332 patients were included in the non-distal IA group. The baseline data for the two groups of patients were compared, and significant differences in aneurysm locations, whether the aneurysm had ruptured, and the width of the aneurysm neck were found between the two groups. In the distal IA group, all stents were successfully placed and released during the operation. No aneurysm rupture occurred during the operation. Immediate postoperative digital subtraction angiography (DSA) showed complete embolization of the aneurysm in 10 patients. Ischemic complications occurred perioperatively in two patients. The postoperative follow-up showed a poor prognosis (modified Rankin scale (mRs) > 2) in three patients and aneurysm recurrence in one patient. No significant differences in the treatment effect, surgical complications, or follow-up results were found between the two groups.
In this series, the use of Atlas SAC for the treatment of distal IAs was not associated with higher complication rates, and shows satisfactory long-term occlusion rates and follow-up results.
探讨Atlas支架治疗颅内远端动脉瘤（IAs）的有效性、安全性及疗效。
回顾性分析2018年1月至2022年1月接受支架辅助弹簧圈栓塞术（SAC）的IAs患者，将其分为两组：接受Atlas SAC治疗的远端IAs患者和接受SAC治疗的其他部位宽颈动脉瘤患者。收集两组患者住院期间的临床资料、影像资料及术后随访资料。
远端IA组纳入15例患者，非远端IA组纳入332例患者。比较两组患者的基线资料，发现两组在动脉瘤位置、动脉瘤是否破裂及瘤颈宽度方面存在显著差异。在远端IA组中，所有支架在手术过程中均成功置入并释放。手术过程中未发生动脉瘤破裂。术后即刻数字减影血管造影（DSA）显示10例患者动脉瘤完全栓塞。围手术期有2例患者发生缺血性并发症。术后随访显示3例患者预后不良（改良Rankin量表（mRs）>2），1例患者动脉瘤复发。两组在治疗效果、手术并发症或随访结果方面未发现显著差异。
在本系列研究中，使用Atlas SAC治疗远端IAs并未导致更高的并发症发生率，且显示出令人满意的长期闭塞率和随访结果。
