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Clinical Safety and Effectiveness of Stent-Assisted Coil Embolization with Neuroform Atlas Stent in Intracranial Aneurysm

Journal of Korean Neurosurgical Society 2020년 63권 1호 p.80 ~ 88
강창현 ( Kim Chang-Hyeun ) - Pusan National University School of Medicine Pusan National University Yangsan Hospital Department of Neurosurgery

김영하 ( Kim Young-Ha ) - Pusan National University School of Medicine Pusan National University Yangsan Hospital Department of Neurosurgery
성순기 ( Sung Soon-Ki ) - Pusan National University School of Medicine Pusan National University Yangsan Hospital Department of Neurosurgery
손동욱 ( Son Dong-Wuk ) - Pusan National University School of Medicine Pusan National University Yangsan Hospital Department of Neurosurgery
송근성 ( Song Geun-Sung ) - Pusan National University School of Medicine Pusan National University Yangsan Hospital Department of Neurosurgery
이상원 ( Lee Sang-Weon ) - Pusan National University School of Medicine Pusan National University Yangsan Hospital Department of Neurosurgery

Abstract


Objective : Stent-assisted coil embolization (SAC) is commonly used for treating wide-neck intracranial aneurysms. In this study, we aimed to assess the clinical safety and efficacy of the NeuroForm Atlas Stent during SAC of intracranial aneurysms.

Methods : We retrospectively analyzed data from patients with ruptured and unruptured cerebral aneurysms, who underwent SAC using the NeuroForm Atlas between February 2018 and July 2018. Favorable clinical outcomes and degree of aneurysm occlusion were defined as a modified Rankin scale score of ≤2 and a Raymond-Roy occlusion classification (RROC) class I/II during the immediate postoperative period and at the 6-month follow-up, respectively.

Results : Thirty-one consecutive patients with 33 cases, including 11 ruptured and 22 unruptured cases were treated via NeuroForm Atlas SAC. Among the 22 unruptured cases with 24 unruptured aneurysms had favorable clinical outcome. Complete occlusion (RROC I) was achieved in 16 aneurysms (66.7%), while neck remnants (RROC II) were observed in six aneurysms (25%). Among the 11 patients with ruptured aneurysms, two died due to re-bleeding and diabetic ketoacidosis. In ruptured cases, RROC I was observed in eight (72.7%) and RROC II was observed in three cases (27.3%). At the 6-month follow-up, no clinical events were observed in the 22 unruptured cases. In the ruptured nine cases, five patients recovered without neurologic deficits, while four experienced unfavorable outcomes at 6 months. Of the 29 aneurysms examined via angiography at the 6-month follow-up, 19 (65.5%) were RROC I, eight (27.6%) were RROC II and two (6.9%) were RROC III. There were no procedure-related hemorrhagic complications.

Conclusion : In this study, we found that stent-assisted coil embolization with NeuroForm Atlas stent may be safe and effective in the treatment of wide-neck intracranial aneurysms. NeuroForm Atlas SAC is feasible for the treatment of both ruptured and unruptured wide-neck aneurysms.

키워드

Intracranial aneurysm; Stents; Coil
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