Midterm Outcomes After Low-Profile Visualization Endoluminal Support or Atlas Stent-Assisted Coiling of Intracranial
Eung Koo Yeon1, Young Dae Cho2, Dong Hyun Yoo2
1Department of Radiology, National Medical Center, Seoul, Korea.
Background:
The interplay of various commercially available stents during coil embolization of intracranial aneurysms and their ultimate impact are subject to debate.
Objective:
To compare midterm outcomes of Low-Profile Visualization Endoluminal Support (LVIS) (MicroVention Inc) and Atlas (Stryker) stent-assisted coiling procedures.
Methods:
A total of 459 intracranial aneurysms subjected to coil embolization using LVIS (n = 318) or Atlas stents (n = 141) between April 2015 and December 2019 were eligible for study. To assess occlusive status postembolization, magnetic resonance angiography and/or conventional angiography were used. The Raymond classification was applied to categorize recanalization. Our analysis was propensity score matched according to probability of stent type deployed.
Results:
Eventually, 41 aneurysms (8.9%) displayed recanalization (minor, 28; major, 13) 6 mo after coiling. Patient age (P = .018), sex (P = .015), aneurysmal location (P < .001), and type of aneurysm (P < .001) differed significantly by group. Overall and major recanalization rates at midterm were similar in both groups (9.1% and 8.5% vs 3.1% and 2.1%, respectively), and there was no significant difference even after 1:1 propensity score matching (odds ratio [OR] = 0.75 [P = .514] and OR = 0.75 [P = .706], respectively).
Conclusion:
In stent-assisted coil embolization of intracranial aneurysms, midterm outcomes of LVIS and Atlas device groups were similar, despite theoretic LVIS superiority. Further randomized comparative studies are needed to confirm our findings.
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