Neuroform atlas versus LVIS-assisted coil embolization of wide-neck intracranial aneurysms: a retrospective cohort study.

Abstract

<h4>Background</h4>Currently, Neuroform Atlas stent and LVIS stent are widely used in assisting coil embolization of wide-necked intracranial aneurysms (WNIAs), but direct comparisons of their safety and effectiveness are rare. This study aims to compare the embolization effect, complications, and prognosis of Neuroform Atlas stent and LVIS stent in assisting coil embolization of WNIAs.<h4>Methods</h4>We retrospectively analyzed 60 patients who underwent coil embolization of WNIAs with the aid of Neuroform Atlas stent or LVIS stent from July 2017 to January 2024. They were divided into Neuroform Atlas group (<i>n</i> = 26) and LVIS group (<i>n</i> = 34). The patients' baseline data, immediate effects, perioperative complications, and follow-up data were collected and compared.<h4>Results</h4>A total of 60 patients with 61 WNIAs underwent stent-assisted coiling with deployment of Atlas (<i>n</i> = 29) or LVIS (<i>n</i> = 34). The immediate complete obliteration (Class I of Modified Raymond-Roy Classification, MRRC) rate of aneurysm was 81.5% (22/27) in the Atlas group and 73.5% (25/34) in the LVIS group. The rates of intraoperative and postoperative ischemic and hemorrhagic complications were 0 and 5.9% (2/34) per patient in the Atlas group and LVIS group, respectively. Follow up digital subtraction angiography (DSA) showed that 88% (22/25) of aneurysms in Atlas group and 87.5% (28/32) of aneurysms in LVIS group were completely occluded with MRRC grade 1. There was no significant difference in the degree of occlusion (<i>p</i> = 0.955) or modified Rankin Scale (mRS) score (<i>p</i> = 0.438) between the two groups at follow-up.<h4>Conclusion</h4>In our single-center retrospective exploratory study, both Neuroform Atlas stent and LVIS stent seem to perform good safety and efficacy in assisting coil embolization of WNIAs, however, further multicenter randomized controlled studies with larger patient series and a longer follow up period will be helpful in elucidation of both the efficacy and the longevity.