Early Multicenter Experience With the Neuroform Atlas Stent: Feasibility, Safety, and Efficacy.
Adult
Aged
Aged, 80 and over
Aortic Dissection
/ surgery
Aneurysm, Ruptured
/ surgery
Endovascular Procedures
/ adverse effects
Feasibility Studies
Female
Humans
Intracranial Aneurysm
/ surgery
Intracranial Arterial Diseases
/ surgery
Male
Middle Aged
Postoperative Complications
/ epidemiology
Retrospective Studies
Stents
Treatment Outcome
Atlas stent
Embolization
Endovascular treatment
Stent-assisted coiling
Journal
Neurosurgery
ISSN: 1524-4040
Titre abrégé: Neurosurgery
Pays: United States
ID NLM: 7802914
Informations de publication
Date de publication:
01 09 2020
01 09 2020
Historique:
received:
29
07
2019
accepted:
05
03
2020
pubmed:
27
5
2020
medline:
26
1
2021
entrez:
27
5
2020
Statut:
ppublish
Résumé
The Neuroform Atlas stent™ (by Stryker, Fremont, California) represents the most recent widely available upgrade to intracranial stenting, providing a laser cut open cell stent with a diameter of 3.0 to 4.5 mm that is delivered through an 0.017-inch microcatheter. To report our initial multicenter experience of the safety, efficacy, and feasibility of the Atlas stent used for treating aneurysms, as well as one case of intracranial stenosis and one carotid artery dissection as well as other pathologies. A retrospective multicenter study of subjects treated with Atlas stent during the period 2018 to 2019. The total number of patients included in our analysis was 71 patients. The stent was utilized to treat 69 aneurysm cases. Of the aneurysms, 36% presented with acute rupture and 56% of the ruptured aneurysms were high grade. Mean aneurysm dimension was 7 mm with an average neck width of 4.1 mm. Around 30% had received prior treatment. Telescoping or Y-stent was used in 16% of cases. We did not observe any symptomatic major complications in our series. Asymptomatic major complications were seen in 7 patients (10.1%); technical complications occurred in 4.3%. Immediate modified Raymond-Roy-occlusion-outcome class I/II was observed in 87%, and this increased to 97.7% at latest follow-up, which was at 4 mo; 91.8% of patients achieved favorable clinical outcome, and mortality rate was 1.4%. Our series demonstrates the safety, feasibility, and efficacy of the Atlas stent. The low complication rate and the high obliteration rate managing complex aneurysms, even in an acute ruptured setting, are notable.
Sections du résumé
BACKGROUND
The Neuroform Atlas stent™ (by Stryker, Fremont, California) represents the most recent widely available upgrade to intracranial stenting, providing a laser cut open cell stent with a diameter of 3.0 to 4.5 mm that is delivered through an 0.017-inch microcatheter.
OBJECTIVE
To report our initial multicenter experience of the safety, efficacy, and feasibility of the Atlas stent used for treating aneurysms, as well as one case of intracranial stenosis and one carotid artery dissection as well as other pathologies.
METHODS
A retrospective multicenter study of subjects treated with Atlas stent during the period 2018 to 2019.
RESULTS
The total number of patients included in our analysis was 71 patients. The stent was utilized to treat 69 aneurysm cases. Of the aneurysms, 36% presented with acute rupture and 56% of the ruptured aneurysms were high grade. Mean aneurysm dimension was 7 mm with an average neck width of 4.1 mm. Around 30% had received prior treatment. Telescoping or Y-stent was used in 16% of cases. We did not observe any symptomatic major complications in our series. Asymptomatic major complications were seen in 7 patients (10.1%); technical complications occurred in 4.3%. Immediate modified Raymond-Roy-occlusion-outcome class I/II was observed in 87%, and this increased to 97.7% at latest follow-up, which was at 4 mo; 91.8% of patients achieved favorable clinical outcome, and mortality rate was 1.4%.
CONCLUSION
Our series demonstrates the safety, feasibility, and efficacy of the Atlas stent. The low complication rate and the high obliteration rate managing complex aneurysms, even in an acute ruptured setting, are notable.
Identifiants
pubmed: 32453816
pii: 5846122
doi: 10.1093/neuros/nyaa143
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
E321-E335Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 by the Congress of Neurological Surgeons.