Introduction When the aneurysm neck is incorporated with the parent vessel, endovascular coiling can be technically more challenging.
Aim of Study This study evaluated the use of a single Neuroform Atlas stent as a safe and effective solution for complex bifurcated aneurysms.
Methods Seventy-six complex bifurcated intracranial aneurysms, including 49 unruptured and 27 ruptured aneurysms, were treated with Neuroform Atlas stent-assisted coil embolization. The clinical and angiographic outcomes were retrospectively analyzed.
Results In 68 patients (mean age, 58.3 ± 11.6 years; male/female ratio, 20 (29.4%):48 (70.6%)), 76 stents were successfully delivered to the target aneurysms, and the technical success rate was 98.6%. There was complete occlusion in 59 (77.6%) of 76 cases, neck remnants in 16 (21.1%) cases, and partial occlusion in 1 (1.3%) case. Two patients experienced treatment-related morbidity: one had branch occlusion and the other suffered from parenchymal hemorrhage, but no unruptured aneurysms showed any new neurologic symptoms at discharge. Of the 27 ruptured aneurysms, 20 had good outcomes (Glasgow Outcome Score 4 or 5) at latest follow-up (mean 12.2 months, range 6–29 months) and 1 died from initial SAH. Post-treatment angiograms showed complete occlusion in 89.1%, neck remnant in 7.8% and incomplete occlusions in 3.1%. 88.2% had at least 1 follow-up diagnostic angiography or MR angiogram (mean 12.5 ± 4.3 months; range 6–29 months) and there were 5 (7.8%) minor and 2 (3.1%) major recurrences.
Conclusion A single Neuroform Atlas stenting is a safe and effective method for treating wide-neck bifurcated aneurysms incorporated with parent vessels.
Disclosure of Interest Nothing to disclose.
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