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Technical, angiographic and clinical outcomes of Neuroform 1, 2, 2 Treo and 3 devices in stent-assisted coiling of intracranial aneurysms
  1. Yasha Kadkhodayan1,
  2. Christopher T Somogyi1,
  3. DeWitte T Cross III1,
  4. Colin P Derdeyn1,
  5. Gregory J Zipfel2,
  6. Michael R Chicoine2,
  7. Keith M Rich2,
  8. Robert L Grubb Jr2,
  9. Ralph G Dacey Jr2,
  10. Christopher J Moran1
  1. 1Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
  2. 2Department of Neurological Surgery, Washington University School of Medicine, St Louis, Missouri, USA
  1. Correspondence to Dr. Christopher J Moran, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S. Kingshighway Blvd, St Louis, MO 63110, USA; moranc{at}mir.wustl.edu

Abstract

Background and purpose Since 2002 the Neuroform stent has expanded endovascular treatment of wide-necked intracranial aneurysms. A study was undertaken to assess the technical success rates and angiographic and clinical outcomes in stent-assisted coiling with Neuroform 1, 2, 2 Treo and 3.

Methods Patients undergoing Neuroform stent-assisted coiling were enrolled in a prospective registry that included 156 stent deployment attempts in 113 consecutive patients (mean age 53, range 25–78). Deployment success and difficulty, stent movement, procedural complications, immediate/delayed aneurysm occlusion and in-stent stenosis on angiographic follow-up were compared among Neuroform 1, 2, 2 Treo and 3 stents using a log likelihood ratio χ2 test.

Results Of 156 stent attempts, 123 (79%) were deployed (Neuroform 1: 8/9 (89%), Neuroform 2: 50/66 (76%), Neuroform 2 Treo: 9/11 (82%), Neuroform 3: 56/70 (80%)) with a symptomatic complication rate of 1.9% (3/156; 2 transient ischemic attacks, 1 stroke, no deaths). Non-target stent placement (1/8 (13%), 6/50 (12%), 2/9 (22%), 3/56 (5%)), difficult placement (2/8 (25%), 10/50 (20%), 5/9 (56%), 6/56 (11%)), stent movement (1/8 (13%), 4/50 (8%), 0/9 (0%), 4/56 (7%)), procedural complications (1/9 (11%), 7/66 (11%), 2/11 (18%), 2/70 (3%)) and immediate near complete aneurysm occlusion (6/6 (100%), 24/37 (65%), 5/7 (71%), 40/45 (89%)) trended towards improvement with each generation. Improvements in difficult stent placement and immediate aneurysm occlusion were significant (p=0.01 and 0.03, respectively).

Conclusion Neuroform stent-assisted coiling has evolved through four generations as a safe and effective means of treating wide-necked intracranial aneurysms.

  • Intracranial aneurysm
  • stent-assisted coil embolization
  • neuroform stent
  • aneurysm
  • coil
  • CT angiography
  • device
  • stent
  • angiography
  • thrombolysis
  • stroke
  • artery
  • cervical
  • vasculitis
  • thrombectomy
  • catheter
  • balloon
  • stenosis
  • hemorrhage
  • brain
  • atherosclerosis
  • angioplasty
  • intervention

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Footnotes

  • Competing interests CJM has served as a consultant, proctor and speaker for Boston Scientific (now Stryker) and has received research support via the MAPS (Matrix and Platinum Science) trial sponsored by Stryker.

  • Ethics approval This study was conducted with the approval of Washington University Human Research Protection Office.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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