4.6 Article

Low-Profile Visualized Intraluminal Support Jr Braided Stent Versus Atlas Self-Expandable Stent for Treatment of Intracranial Aneurysms: A Single Center Experience

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NEUROSURGERY
卷 88, 期 2, 页码 E170-E178

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OXFORD UNIV PRESS INC
DOI: 10.1093/neuros/nyaa458

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Aneurysm; Ruptured; Angioplasty; Intracranial aneurysm; Stents

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This study compared the technical performance and outcomes of the Atlas and LVIS Jr stents in treating intracranial aneurysms. Both devices showed favorable clinical outcomes and angiographic results at follow-up, with low rates of recurrence and retreatment. However, the LVIS Jr stent had more technical problems compared to the Atlas stent.
BACKGROUND: The Neuroform Atlas Stent and Low-profile Visualized Intraluminal Support (LVIS) and LVIS Jr stents are used to treat intracranial aneurysms (IAs), but their safety, performance, and outcomes have not been directly compared. OBJECTIVE: To compare the technical performance and outcomes of Atlas and LVIS Jr stents for treatment of IAs. METHODS: IAs treated by stent-assisted coiling using an Atlas (Stryker, Kalamazoo, Michigan) or LVIS Jr (MicroVention, Aliso Viejo, California) device between January 2014 to November 2019 were retrospectively evaluated. Patient demographics, aneurysm size and location, technical difficulties, and clinical and angiographic follow-up were analyzed. RESULTS: A total of 116 patients, (mean age 64.2 11.8 yr, 72.7% female) with 121 aneurysms underwent stent-assisted coiling with deployment of Atlas (n = 64) or LVIS Jr (n = 57) stents. Mean aneurysm size was 6.2 +/- 2.7 mm. Immediate rates of Raymond-Roy (RR) 1/2 were 89.0% (57/64) and 80.7% (46/57) for the Atlas and LVIS Jr groups, respectively. Neither group had major postoperative thromboembolic complications; however, 15.8% (9/57) of the LVIS Jr procedures had technical issues. Additionally, 88.5% (46/52) and 91.2% (33/36) of patients in the Atlas and LVIS Jr groups had RR 1/2 at a mean follow-up of 13.6 and 18.7 mo, respectively. CONCLUSION: Treatment of IAs with Atlas and LVIS Jr stents results in favorable clinical outcomes and angiographic results at follow-up, with low rates of recurrence and retreatment, suggesting both devices are safe and effective. Notably, LVIS Jr had more technical problems than Atlas.

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