Yu Shik Shim1, Sang Kyu Park2, Joonho Chung3. 1. Department of Neurosurgery, Inha University College of Medicine, Incheon, Republic of Korea. 2. Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Republic of Korea. Electronic address: ns.joonho.chung@gmail.com.
Abstract
OBJECTIVES: Although stent-salvage technique has been well-known to rescue the situation of coil protrusion into the parent artery aggravating to make thromboembolism, the smallest profiled Neuroform Atlas stent can be expected to handle those situations easily compared to previously used intracranial stents. Thus, the purpose of this study was to report our series of stent salvage using the Neuroform Atlas stent for procedure-related complications during coil embolization of intracranial aneurysms. PATIENTS AND METHODS: In March 2018, the Neuroform Atlas was approved for use in our country. Since then, we have treated 541 aneurysms in 502 patients with coil embolization. There were 15 consecutive cases (14 unruptured and 1 ruptured) with procedure-related complications, such as coil protrusion or parent artery thrombosis, rescued by the Neuroform Atlas stent. Follow-up angiography was performed in 14 of the 15 patients between 6-12 months (mean 8.2 months) after the procedure, and clinical follow-up was performed from 2 to 18 months (mean 11.2 months) after the procedure. RESULTS: Procedure-related complications included parent artery thrombosis due to coil herniation (n = 5) and coil protrusion floating in the parent artery (n = 10). There was no complication related to delivery or deploy of Neuroform Atlas stents. In 12 (80.0 %) of the 15 cases, the stent was deployed via the same microcatheter for coil delivery. In 3 cases of wide neck aneurysms, the stent was deployed via another microcatheter per the scheduled stent-assisted or double microcatheter techniques. Initial angiographic results showed 11 (73.3 %, 11/15) cases of complete occlusion, and 12 (85.7 %, 12/14) cases achieved complete occlusion in follow-up angiographies. CONCLUSIONS: Facing with procedure-related complications during coil embolization of intracranial aneurysms, the smallest profiled Neuroform Atlas stent might be a time-saving and feasible option for the salvage technique by using the same microcatheter to deliver coils.
OBJECTIVES: Although stent-salvage technique has been well-known to rescue the situation of coil protrusion into the parent artery aggravating to make thromboembolism, the smallest profiled Neuroform Atlas stent can be expected to handle those situations easily compared to previously used intracranial stents. Thus, the purpose of this study was to report our series of stent salvage using the Neuroform Atlas stent for procedure-related complications during coil embolization of intracranial aneurysms. PATIENTS AND METHODS: In March 2018, the Neuroform Atlas was approved for use in our country. Since then, we have treated 541 aneurysms in 502 patients with coil embolization. There were 15 consecutive cases (14 unruptured and 1 ruptured) with procedure-related complications, such as coil protrusion or parent artery thrombosis, rescued by the Neuroform Atlas stent. Follow-up angiography was performed in 14 of the 15 patients between 6-12 months (mean 8.2 months) after the procedure, and clinical follow-up was performed from 2 to 18 months (mean 11.2 months) after the procedure. RESULTS: Procedure-related complications included parent artery thrombosis due to coil herniation (n = 5) and coil protrusion floating in the parent artery (n = 10). There was no complication related to delivery or deploy of Neuroform Atlas stents. In 12 (80.0 %) of the 15 cases, the stent was deployed via the same microcatheter for coil delivery. In 3 cases of wide neck aneurysms, the stent was deployed via another microcatheter per the scheduled stent-assisted or double microcatheter techniques. Initial angiographic results showed 11 (73.3 %, 11/15) cases of complete occlusion, and 12 (85.7 %, 12/14) cases achieved complete occlusion in follow-up angiographies. CONCLUSIONS: Facing with procedure-related complications during coil embolization of intracranial aneurysms, the smallest profiled Neuroform Atlas stent might be a time-saving and feasible option for the salvage technique by using the same microcatheter to deliver coils.