RT Journal Article SR Electronic T1 Transcirculation approach for stent-assisted coiling of intracranial aneurysms: a multicenter study JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 711 OP 715 DO 10.1136/neurintsurg-2020-016899 VO 13 IS 8 A1 Mascitelli, Justin R A1 Levitt, Michael R A1 Griessenauer, Christoph J A1 Kim, Louis J A1 Gross, Bradley A1 Abla, Adib A1 Winkler, Ethan A1 Jankowitz, Brian A1 Grandhi, Ramesh A1 Goren, Oded A1 Schirmer, Clemens M YR 2021 UL http://jnis.bmj.com/content/13/8/711.abstract AB Background The transcirculation approach (TCA) for stent-assisted coiling (SAC) of intracranial aneurysms may be useful for certain wide-neck bifurcation aneurysms as well as those with acute-angle efferent branches.Objective To describe a multicenter experience using the TCA for SAC.Methods A multicenter, retrospective study (2016–2020) of aneurysm treatment using SAC via the TCA. Angiographic outcome was scored using the Raymond Scale (adequate occlusion 1 and 2), and clinical outcome was scored using a modified Rankin Scale (good outcome 0–2)Results Twenty-nine patients with 29 aneurysms were included (62.1% female; average age 61; 89.7% unruptured; 13.8% previously treated; average dome size 6.4 mm; average neck 4.4 mm). Aneurysm locations included internal carotid artery–fetal posterior cerebral artery (n=4), internal carotid artery terminus (n=4), anterior communicating artery (n=8), vertebral artery–posterior inferior cerebellar artery (n=2), and basilar tip (n=11). The TCA used communicating arteries (93.1%; average 1.6 mm), intermediate catheters (51.7%), jailing technique (62.1%), and staged procedures (10.3%). The most common stent was the Neuroform Atlas (Stryker; 69%). Immediate adequate occlusion was obtained in 75.9%, and five patients with inadequate occlusion progressed to adequate occlusion at follow-up. One (3.4%) procedural complication occurred: a watershed stroke in the setting of baseline four-vessel extracranial disease. Two patients had a poor outcome unrelated to the TCA. The majority of patients (86.4%) had a good clinical outcome. One case of in-stent stenosis due to non-compliance with medication was seen, which resolved with medication resumption.Conclusions The TCA for SAC can be performed for a variety of aneurysms with a low complication rate and good clinical outcomes.