AJNR. American journal of neuroradiology · 2026
Efficacy and Safety of Stent-Assisted Coiling with Low-Profile Visualized Intraluminal Support versus Neuroform Atlas for Unruptured Internal Carotid Aneurysms: A Propensity Score-Matched Analysis.
СтатьяСравнительное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Nagayama Gota, Fuga Michiyasu, Ishibashi Toshihiro, Aoki Ken, Tachi Rintaro, Kato Naoki, Kan Issei, Hataoka Shunsuke, Sano Tohru, Horiuchi Kazufumi, Murayama Yuichi
Аннотация
BACKGROUND AND PURPOSE: Stent-assisted coiling (SAC) is widely used for the treatment of wide-neck, unruptured intracranial aneurysms. However, direct comparative data between different stent platforms remain limited. This study aimed to evaluate the safety and efficacy of the Low-profile Visualized Intraluminal Support (LVIS) stent versus the Neuroform Atlas stent in the treatment of unruptured ICA aneurysms measuring <10 mm in diameter.
MATERIALS AND METHODS: A retrospective analysis was performed on 287 unruptured ICA aneurysms (<10 mm) in 247 patients treated with SAC using either the LVIS or Neuroform Atlas stent across 3 affiliated institutions between March 2017 and December 2023. Patients were divided into 2 groups: group A (Neuroform Atlas) and group L (LVIS). After 1:1 propensity score matching for demographic, clinical, anatomic, and procedural variables, key outcomes including Raymond class 1 occlusion, volume embolization ratio, and periprocedural complications were compared between the 2 groups.
RESULTS: Among the 287 aneurysms, 237 (82.6%) were treated with the Neuroform Atlas stent and 50 (17.4%) with the LVIS stent. Propensity score matching yielded 46 matched pairs. Immediately after treatment, group L demonstrated significantly higher rates of complete occlusion and a greater volume embolization ratio compared with group A (P = .022 and .004, respectively). At the 1-year follow-up, the complete occlusion rate remained significantly higher in group L than in group A (52% versus 24%; P = .007). The incidence of ischemic and hemorrhagic complications did not differ significantly between the 2 groups.
CONCLUSIONS: For unruptured ICA aneurysms <10 mm in diameter, SAC using the LVIS stent was associated with a significantly higher rate of complete occlusion at 1 year compared with the Neuroform Atlas stent, without an increase in periprocedural complications. These results support the safety and efficacy of the LVIS stent in achieving favorable long-term angiographic outcomes in small- to medium-sized unruptured ICA aneurysms.
MATERIALS AND METHODS: A retrospective analysis was performed on 287 unruptured ICA aneurysms (<10 mm) in 247 patients treated with SAC using either the LVIS or Neuroform Atlas stent across 3 affiliated institutions between March 2017 and December 2023. Patients were divided into 2 groups: group A (Neuroform Atlas) and group L (LVIS). After 1:1 propensity score matching for demographic, clinical, anatomic, and procedural variables, key outcomes including Raymond class 1 occlusion, volume embolization ratio, and periprocedural complications were compared between the 2 groups.
RESULTS: Among the 287 aneurysms, 237 (82.6%) were treated with the Neuroform Atlas stent and 50 (17.4%) with the LVIS stent. Propensity score matching yielded 46 matched pairs. Immediately after treatment, group L demonstrated significantly higher rates of complete occlusion and a greater volume embolization ratio compared with group A (P = .022 and .004, respectively). At the 1-year follow-up, the complete occlusion rate remained significantly higher in group L than in group A (52% versus 24%; P = .007). The incidence of ischemic and hemorrhagic complications did not differ significantly between the 2 groups.
CONCLUSIONS: For unruptured ICA aneurysms <10 mm in diameter, SAC using the LVIS stent was associated with a significantly higher rate of complete occlusion at 1 year compared with the Neuroform Atlas stent, without an increase in periprocedural complications. These results support the safety and efficacy of the LVIS stent in achieving favorable long-term angiographic outcomes in small- to medium-sized unruptured ICA aneurysms.