Neuroform Atlas Stent Treatment for 533 Intracranial Aneurysms in a Large Chinese Cohort: Complication Risk Factor Analysis

Abstract

Purpose The newest generation Neuroform Atlas stent™ (by Stryker, Fremont, California)represents a recent advance in cerebral laser-cut microstents for the treatment of intracranial wide-necked aneurysms and the postoperative complications have been observed in cases among Western populations.We assessed predictors of complications, morbidity, and unfavorable outcomes in a large cohort of patients with aneurysm treated with Neuroform Atlas stent in China. Methods This retrospective study included subjects treated with the Atlas stent in China from November 2020 to January 2022. Results A total of 522 consecutive patients (mean age, 58.9 ± 9.9 years; female, 65.3% [341/522]) with 533 aneurysms were included in the study. In the early postoperative period, neurological morbidity rate was 7.3% (38/522); ischaemic stroke rate was 5.0% (26/522); aneurysm rupture subarachnoid hemorrhage rate was 2.3% (12/522); MRS score deterioration rate was 5.4% (28/522). Mortality rate were 0.8% (4/522) in the postoperative period. Neurologic morbidity at follow-up period were 1.2% (6/486). In multi-factor prediction, cerebral infarction, Hunt-Hess Grade (3–5), procedure duration, stent length and coil protrusion into the parent artery were found to be independent predictors of neurologic morbidity. Procedure duration, stent length and coil protrusion into the parent artery were found to be independent predictors of neurological mRS score deterioration. Conclusion The incidence of SCA (stent-assisted coiling)-related complications with the Atlas stent in this study was comparable to that in the Western population. We identified procedure duration and stent length as novel independent predictors of SCA-related ischemic stroke, neurologic morbidity, and mRS score deterioration among the Chinese population.