Antonio A Caragliano1, Rosario Papa2, Antonio Pitrone2, Nicola Limbucci3, Sergio Nappini3, Maria Ruggiero4, Emiliano Visconti4, Andrea Alexandre5, Roberto Menozzi6, Dario Lauretti7, Nicola Cavasin8, Angela Alibrandi9, Agostino Tessitore2, Marcello Longo2, Sergio L Vinci2. 1. Neuroradiology Unit, Biomedical Sciences and of Morphologic and Functional Images, AOU Policlinico G. Martino, Messina, Italy. Electronic address: caraglia1987@gmail.com. 2. Neuroradiology Unit, Biomedical Sciences and of Morphologic and Functional Images, AOU Policlinico G. Martino, Messina, Italy. 3. Neurovascular Interventional Unit, Careggi University Hospital, Florence, Italy. 4. Neuroradiology Unit, AUSL Romagna, Cesena, Italy. 5. Institute of Radiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy. 6. Neurovascular Interventional Unit, AOU Parma, Parma, Italy. 7. Neuroradiology Unit, Department of translation research and new technologies in medicine and surgery, University of Pisa, Pisa, Italy. 8. Neuroradiology Unit, Department of Radiology, Ospedale dell'Angelo, Mestre, Venezia, Italy. 9. Department of Economics, Unit of Statistical and Mathematical Sciences, AOU Policlinico G. Martino, Messina, Italy.
Abstract
BACKGROUND AND PURPOSE: Wide-necked brain aneurysms therapy remains a challenge for neurointerventionalists, mainly for the high recurrence rate. Low-profile stents make feasible the treatment of these aneurysms. In our multicenter series we analyzed clinical and angiographic results of Neuroform Atlas stent-assisted coiling. MATERIALS AND METHODS: From January 2016 to March 2017, 113 wide-necked aneurysms were discovered with CTA, MRA and DSA. The Atlas stent-assisted coiling procedures were performed under general anesthesia with sequential or jailing techniques. Six months follow-up DSA was performed to assess the recurrence rate through the modified Raymond-Roy occlusion scale (RROC). Moreover, patients were evaluated clinically to analyse the degree of disability according to the mRS. MRI was performed at 12 months evaluating both the cerebral tissue and the vessels. RESULTS: In all the procedures it was feasible to navigate the Neuroform Atlas to the goal vessel and deploy the stent across the aneurysmal neck. Intra-procedural complications account for the 6.2% (7/113). The immediate occlusion rate was RROC 1 in 88%, 2 in 9% and 3 in 3% of cases. The 6 months clinical data showed mRS Score 0-1 in 96.5% of patients; 3 patients died of complications related to SAH. The 12 months follow-up showed RROC of 1 in 82%, 2 in 13% and 3 in 5% of cases. No aneurysm has been retreated. CONCLUSIONS: In our multicenter experience the Neuroform Atlas stent assisted-coiling has shown to be a safe and effective technique for the treatment of wide-necked intracranial aneurysms with encouraging clinical and angiographic results.
BACKGROUND AND PURPOSE: Wide-necked brain aneurysms therapy remains a challenge for neurointerventionalists, mainly for the high recurrence rate. Low-profile stents make feasible the treatment of these aneurysms. In our multicenter series we analyzed clinical and angiographic results of Neuroform Atlas stent-assisted coiling. MATERIALS AND METHODS: From January 2016 to March 2017, 113 wide-necked aneurysms were discovered with CTA, MRA and DSA. The Atlas stent-assisted coiling procedures were performed under general anesthesia with sequential or jailing techniques. Six months follow-up DSA was performed to assess the recurrence rate through the modified Raymond-Roy occlusion scale (RROC). Moreover, patients were evaluated clinically to analyse the degree of disability according to the mRS. MRI was performed at 12 months evaluating both the cerebral tissue and the vessels. RESULTS: In all the procedures it was feasible to navigate the Neuroform Atlas to the goal vessel and deploy the stent across the aneurysmal neck. Intra-procedural complications account for the 6.2% (7/113). The immediate occlusion rate was RROC 1 in 88%, 2 in 9% and 3 in 3% of cases. The 6 months clinical data showed mRS Score 0-1 in 96.5% of patients; 3 patients died of complications related to SAH. The 12 months follow-up showed RROC of 1 in 82%, 2 in 13% and 3 in 5% of cases. No aneurysm has been retreated. CONCLUSIONS: In our multicenter experience the Neuroform Atlas stent assisted-coiling has shown to be a safe and effective technique for the treatment of wide-necked intracranial aneurysms with encouraging clinical and angiographic results.
Authors: K Y Park; J Y Yeon; B M Kim; P Jeon; J-H Kim; C K Jang; D J Kim; J W Lee; Y B Kim; J Chung; D H Song; H G Park; J S Park Journal: AJNR Am J Neuroradiol Date: 2020-03-12 Impact factor: 3.825
Authors: J-K Burkhardt; V Srinivasan; A Srivatsan; F Albuquerque; A F Ducruet; B Hendricks; B A Gross; B T Jankowitz; A J Thomas; C S Ogilvy; G A Maragkos; A Enriquez-Marulanda; R W Crowley; M R Levitt; L J Kim; C J Griessenauer; C M Schirmer; S Dalal; K Piper; M Mokin; E A Winkler; A A Abla; C McDougall; L Birnbaum; J Mascitelli; M Litao; O Tanweer; H Riina; J Johnson; S Chen; P Kan Journal: AJNR Am J Neuroradiol Date: 2020-05-28 Impact factor: 3.825
Authors: Brian T Jankowitz; Ashutosh P Jadhav; Bradley Gross; Tudor G Jovin; Abdulnasser A Alhajeri; Justin F Fraser; Ricardo A Hanel; Eric Sauvageau; Amin Aghaebrahim; Donald Frei; Richard Bellon; David Loy; Ajit S Puri; Adel M Malek; Ajith Thomas; Gabor Toth; Demetrius Klee Lopes; R Webster Crowley; Adam S Arthur; John Reavey-Cantwell; Eugene Lin; Adnan H Siddiqui; Michael J Alexander; Ahmad Khaldi; Geoffrey P Colby; Justin M Caplan; Sudhakar R Satti; Aquilla S Turk; Alejandro M Spiotta; Richard Klucznik; Danial K Hallam; David Kung; Michael T Froehler; R Charles Callison; Peter Kan; Steven W Hetts; Osama O Zaidat Journal: J Neurointerv Surg Date: 2021-03-15 Impact factor: 5.836