Multicenter postmarket analysis of the neuroform atlas stent for stent-assisted coil embolization of intracranial aneurysms

J. K. Burkhardt, V. Srinivasan, A. Srivatsan, F. Albuquerque, A. F. Ducruet, B. Hendricks, B. A. Gross, B. T. Jankowitz, A. J. Thomas, C. S. Ogilvy, G. A. Maragkos, A. Enriquez-Marulanda, R. W. Crowley, M. R. Levitt, L. J. Kim, C. J. Griessenauer, C. M. Schirmer, S. Dalal, K. Piper, M. MokinE. A. Winkler, A. A. Abla, C. McDougall, L. Birnbaum, J. Mascitelli, M. Litao, O. Tanweer, H. Riina, J. Johnson, S. Chen, P. Kan

Research output: Contribution to journalArticle

Abstract

Background and Purpose: The Neuroform Atlas is a new microstent to assist coil embolization of intracranial aneurysms that recently gained FDA approval. We present a postmarket multicenter analysis of the Neuroform Atlas stent. Materials and Methods: On the basis of retrospective chart review from 11 academic centers, we analyzed patients treated with the Neuroform Atlas after FDA exemption from January 2018 to June 2019. Clinical and radiologic parameters included patient demographics, aneurysm characteristics, stent parameters, complications, and outcomes at discharge and last follow-up. Results: Overall, 128 aneurysms in 128 patients (median age, 62 years) were treated with 138 stents. Risk factors included smoking (59.4%), multiple aneurysms (27.3%), and family history of aneurysms (16.4%). Most patients were treated electively (93.7%), and 8 (6.3%) underwent treatment within 2 weeks of subarachnoid hemorrhage. Previous aneurysm treatment failure was present in 21% of cases. Wide-neck aneurysms (80.5%), small aneurysm size (<7 mm, 76.6%), and bifurcation aneurysm location (basilar apex, 28.9%; anterior communicating artery, 27.3%; and middle cerebral artery bifurcation, 12.5%) were common. A single stent was used in 92.2% of cases, and a single catheter for both stent placement and coiling was used in 59.4% of cases. Technical complications during stent deployment occurred in 4.7% of cases; symptomatic thromboembolic stroke, in 2.3%; and symptomatic hemorrhage, in 0.8%. Favorable Raymond grades (Raymond-Roy occlusion classification) I and II were achieved in 82.9% at discharge and 89.5% at last follow-up. mRS ≤2 was determined in 96.9% of patients at last follow-up. The immediate Raymond-Roy occlusion classification grade correlated with aneurysm location (P<.0001) and rupture status during treatment (P=.03). Conclusions: This multicenter analysis provides a real-world safety and efficacy profile for the treatment of intracranial aneurysms with the Neuroform Atlas stent.

Original languageEnglish (US)
Pages (from-to)1037-1042
Number of pages6
JournalAmerican Journal of Neuroradiology
Volume41
Issue number6
DOIs
StatePublished - Jun 1 2020
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

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    Burkhardt, J. K., Srinivasan, V., Srivatsan, A., Albuquerque, F., Ducruet, A. F., Hendricks, B., Gross, B. A., Jankowitz, B. T., Thomas, A. J., Ogilvy, C. S., Maragkos, G. A., Enriquez-Marulanda, A., Crowley, R. W., Levitt, M. R., Kim, L. J., Griessenauer, C. J., Schirmer, C. M., Dalal, S., Piper, K., ... Kan, P. (2020). Multicenter postmarket analysis of the neuroform atlas stent for stent-assisted coil embolization of intracranial aneurysms. American Journal of Neuroradiology, 41(6), 1037-1042. https://doi.org/10.3174/ajnr.A6581