Abstract WP89: Preliminary Single-center Experience with Neuroform Atlas Stent-assisted Coiling for Unruptured Intracranial Aneurysms

Background and Purpose: Expandable stents have broadened the spectrum of endovascular treatment of intracranial aneurysms. The Neuroform ATLAS, a nitinol self-expanding, hybrid/open-cell stent, is the evolution of the Neuroform EZ supposing to ease the navigability of the system into intra-cranial arteries, through a low-profile 0.017 inch delivery catheter. We present herein our initial experience in the treatment of intracranial aneurysms with this stent. Materials and Method: We compiled data from consecutive patients of our institution from July 2015 to June 2016 who underwent stent-assisted coiling with the Neuroform ATLAS. Clinical and angiographic results were analyzed retrospectively. Results: Thirty-six intracranial saccular aneurysms (18 MCA, 10 AcoA, 4 ICA bifurcation, 2 basilar tip, 1 vertebral-PICA, 1 pericallosal artery) in 35 patients (24 women, 11 men, mean age 60 years) were consecutively treated. The stent was used in 32 previously untreated aneurysms, and in 4 cases of recanalization. One single stent was used in 15 aneurysms while 21 aneurysms (58.3%) were treated with 2 stents in a “Y” configuration. The immediate post-treatment angiography showed a complete occlusion in 19 cases (52.7%), a residual neck in 4 cases (11.1%) and a residual aneurysmal contrast filling in 13 cases (36.1%). Two complications occurred (5.5%), the first due to an associated aneurysm perforation (mRs 1), and the second due to parent vessel perforation (mRs 6). Both of them occurred after the stent implantation. We don’t report any case of attempted stenting treatment. Conclusion: The Neuroform ATLAS Delivery System is an effective device for treatment of complex intracranial aneurysms, allowing good conformability and stability with a high level of navigability. The 2 main advantages are its low profile and the cell-design allowing easy mesh crossing to perform Y-stenting procedures. Key words: Neuroform ATLAS, Neuroform EZ, Stent-assisted coiling, cerebral aneurysm. Abbreviations: mRs: modified Rankin Scale, AcoA: Anterior communicating artery, PICA: posterior inferior cerebellar artery.