Skip to main content
Erschienen in: Clinical Neuroradiology 4/2021

30.11.2020 | Original Article

Safety and Efficacy of the Neuroform Atlas Stent for Treatment of Intracranial Aneurysms

A Systematic Review and Meta-Analysis

verfasst von: Jeremy Lynch, Sara Sciacca, Juveria Siddiqui, Lakshmi Kanagarajah, Shahram Derakhshani

Erschienen in: Clinical Neuroradiology | Ausgabe 4/2021

Einloggen, um Zugang zu erhalten

Abstract

Objective

The Neuroform Atlas (Stryker Neurovascular, Fremont, CA, USA) is a low-profile laser cut self-expanding nitinol stent designed to provide coil support and wall apposition during aneurysm embolisation. In this study, we performed a meta-analysis of outcomes after treatment with the Neuroform Atlas stent for the purpose of coil embolisation.

Methods

The primary objectives of this meta-analysis were to define the safety (treatment-related complications, neurologic outcomes, mortality rate) and the efficacy (aneurysm occlusion rate) of the treatment of intracranial aneurysms with the Neuroform Atlas stent. A systematic review and meta-analysis was performed by searching PubMed, EMBASE, and the Cochrane CENTRAL Library for all published studies on the treatment of intracranial aneurysms with the Neuroform Atlas device up to 6 April 2020. The review was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Results

A total of 14 studies were analysed (577 patients with 593 intracranial aneurysms). The mean age was 58.2 years and 35.6% were male. Technical success of the procedure was 100%. RROC1/RROC2 (Raymond-Roy occlusion classification (RROC) 1/2) (total occlusion/neck remnant) at a mean follow-up of 8.9 months was achieved in 94.8%. RROC3 was 4.9%. All-cause mortality was 1.8% and permanent residual neurological deficit or disability was 2.7%. Overall complications at follow-up were 6.2%.

Conclusion

Our analysis demonstrated good rates of occlusion at follow-up for aneurysms treated with the Atlas device at follow-up. The safety profile appears similar to other low-profile intracranial stents.
Literatur
1.
Zurück zum Zitat McLaughlin N, McArthur DL, Martin NA. Use of stent-assisted coil embolization for the treatment of wide-necked aneurysms: A systematic review. Surg Neurol Int. 2013;4:43.CrossRef McLaughlin N, McArthur DL, Martin NA. Use of stent-assisted coil embolization for the treatment of wide-necked aneurysms: A systematic review. Surg Neurol Int. 2013;4:43.CrossRef
2.
Zurück zum Zitat Fiorella D, Albuquerque FC, Han P, McDougall CG. Preliminary experience using the Neuroform stent for the treatment of cerebral aneurysms. Neurosurgery. 2004;54:6–16; discussion 16–7.CrossRef Fiorella D, Albuquerque FC, Han P, McDougall CG. Preliminary experience using the Neuroform stent for the treatment of cerebral aneurysms. Neurosurgery. 2004;54:6–16; discussion 16–7.CrossRef
3.
Zurück zum Zitat Howington JU, Hanel RA, Harrigan MR, Levy EI, Guterman LR, Hopkins LN. The Neuroform stent, the first microcatheter-delivered stent for use in the intracranial circulation. Neurosurgery. 2004;54:2–5.CrossRef Howington JU, Hanel RA, Harrigan MR, Levy EI, Guterman LR, Hopkins LN. The Neuroform stent, the first microcatheter-delivered stent for use in the intracranial circulation. Neurosurgery. 2004;54:2–5.CrossRef
4.
Zurück zum Zitat Shapiro M, Becske T, Sahlein D, Babb J, Nelson PK. Stent-supported aneurysm coiling: a literature survey of treatment and follow-up. AJNR Am J Neuroradiol. 2012;33:159–63.CrossRef Shapiro M, Becske T, Sahlein D, Babb J, Nelson PK. Stent-supported aneurysm coiling: a literature survey of treatment and follow-up. AJNR Am J Neuroradiol. 2012;33:159–63.CrossRef
5.
Zurück zum Zitat Lopes DK, Johnson AK, Kellogg RG, Heiferman DM, Keigher KM. Long-term radiographic results of stent-assisted embolization of cerebral aneurysms. Neurosurgery. 2014;74:286–91.CrossRef Lopes DK, Johnson AK, Kellogg RG, Heiferman DM, Keigher KM. Long-term radiographic results of stent-assisted embolization of cerebral aneurysms. Neurosurgery. 2014;74:286–91.CrossRef
6.
Zurück zum Zitat Chalouhi N, Starke RM, Koltz MT, Jabbour PM, Tjoumakaris SI, Dumont AS, Rosenwasser RH, Singhal S, Gonzalez LF. Stent-assisted coiling versus balloon remodeling of wide-neck aneurysms: comparison of angiographic outcomes. AJNR Am J Neuroradiol. 2013;34:1987–92.CrossRef Chalouhi N, Starke RM, Koltz MT, Jabbour PM, Tjoumakaris SI, Dumont AS, Rosenwasser RH, Singhal S, Gonzalez LF. Stent-assisted coiling versus balloon remodeling of wide-neck aneurysms: comparison of angiographic outcomes. AJNR Am J Neuroradiol. 2013;34:1987–92.CrossRef
7.
Zurück zum Zitat Lopes D, Sani S. Histological postmortem study of an internal carotid artery aneurysm treated with the Neuroform stent. Neurosurgery. 2005;56:E416; discussion E416. Lopes D, Sani S. Histological postmortem study of an internal carotid artery aneurysm treated with the Neuroform stent. Neurosurgery. 2005;56:E416; discussion E416.
8.
Zurück zum Zitat Aydin K, Arat A, Sencer S, Barburoglu M, Men S. Stent-Assisted Coiling of Wide-Neck Intracranial Aneurysms Using Low-Profile LEO Baby Stents: Initial and Midterm Results. AJNR Am J Neuroradiol. 2015;36:1934–41.CrossRef Aydin K, Arat A, Sencer S, Barburoglu M, Men S. Stent-Assisted Coiling of Wide-Neck Intracranial Aneurysms Using Low-Profile LEO Baby Stents: Initial and Midterm Results. AJNR Am J Neuroradiol. 2015;36:1934–41.CrossRef
9.
Zurück zum Zitat Möhlenbruch M, Herweh C, Behrens L, Jestaedt L, Amiri H, Ringleb PA, Bendszus M, Pham M. The LVIS Jr. microstent to assist coil embolization of wide-neck intracranial aneurysms: clinical study to assess safety and efficacy. Neuroradiology. 2014;56:389–95.CrossRef Möhlenbruch M, Herweh C, Behrens L, Jestaedt L, Amiri H, Ringleb PA, Bendszus M, Pham M. The LVIS Jr. microstent to assist coil embolization of wide-neck intracranial aneurysms: clinical study to assess safety and efficacy. Neuroradiology. 2014;56:389–95.CrossRef
10.
Zurück zum Zitat Park SY, Oh JS, Oh HJ, Yoon SM, Bae HG. Safety and Efficacy of Low-Profile, Self-Expandable Stents for Treatment of Intracranial Aneurysms: Initial and Midterm Results - A Systematic Review and Meta-Analysis. Interv Neurol. 2017;6:170–82.CrossRef Park SY, Oh JS, Oh HJ, Yoon SM, Bae HG. Safety and Efficacy of Low-Profile, Self-Expandable Stents for Treatment of Intracranial Aneurysms: Initial and Midterm Results - A Systematic Review and Meta-Analysis. Interv Neurol. 2017;6:170–82.CrossRef
11.
Zurück zum Zitat Jankowitz BT, Hanel R, Jadhav AP, Loy DN, Frei D, Siddiqui AH, Puri AS, Khaldi A, Turk AS, Malek AM, Sauvageau E, Hetts SW, Zaidat OO. Neuroform Atlas Stent System for the treatment of intracranial aneurysm: primary results of the Atlas Humanitarian Device Exemption cohort. J Neurointerv Surg. 2019;11:801–6.CrossRef Jankowitz BT, Hanel R, Jadhav AP, Loy DN, Frei D, Siddiqui AH, Puri AS, Khaldi A, Turk AS, Malek AM, Sauvageau E, Hetts SW, Zaidat OO. Neuroform Atlas Stent System for the treatment of intracranial aneurysm: primary results of the Atlas Humanitarian Device Exemption cohort. J Neurointerv Surg. 2019;11:801–6.CrossRef
12.
Zurück zum Zitat Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336–41. Erratum in: Int J Surg. 2010;8:658.CrossRef Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 2010;8:336–41. Erratum in: Int J Surg. 2010;8:658.CrossRef
13.
Zurück zum Zitat Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001;32:1998–2004.CrossRef Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001;32:1998–2004.CrossRef
14.
Zurück zum Zitat Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–5.CrossRef Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25:603–5.CrossRef
15.
Zurück zum Zitat Ciccio G, Robert T, Smajda S, Fahed R, Desilles JP, Redjem H, Escalard S, Mazighi M, Blanc R, Piotin M. Double stent assisted coiling of intracranial bifurcation aneurysms in Y and X configurations with the Neuroform ATLAS stent: immediate and mid term angiographic and clinical follow-up. J Neurointerv Surg. 2019;11:1239–42.CrossRef Ciccio G, Robert T, Smajda S, Fahed R, Desilles JP, Redjem H, Escalard S, Mazighi M, Blanc R, Piotin M. Double stent assisted coiling of intracranial bifurcation aneurysms in Y and X configurations with the Neuroform ATLAS stent: immediate and mid term angiographic and clinical follow-up. J Neurointerv Surg. 2019;11:1239–42.CrossRef
17.
Zurück zum Zitat Baek JW, Jin SC, Kim JH, Yoo MW, Jeong HW, Seo JH, Han JY, Heo YJ, Kim ST. Initial multicentre experience using the neuroform atlas stent for the treatment of un-ruptured saccular cerebral aneurysms. Br J Neurosurg. 2020;34:333–8. Baek JW, Jin SC, Kim JH, Yoo MW, Jeong HW, Seo JH, Han JY, Heo YJ, Kim ST. Initial multicentre experience using the neuroform atlas stent for the treatment of un-ruptured saccular cerebral aneurysms. Br J Neurosurg. 2020;34:333–8.
18.
Zurück zum Zitat Pan S, Kannath SK, Rajan JE. Low-Profile Neuroform Atlas Stent-Assisted Coiling of Intracranial Aneurysms: Single-Center Initial Experience. J Clin Interv Radiol Isvir. 2019;03:117–21.CrossRef Pan S, Kannath SK, Rajan JE. Low-Profile Neuroform Atlas Stent-Assisted Coiling of Intracranial Aneurysms: Single-Center Initial Experience. J Clin Interv Radiol Isvir. 2019;03:117–21.CrossRef
19.
Zurück zum Zitat Park KY, Jang CK, Lee JW, Kim DJ, Kim BM, Chung J. Preliminary experience of stent-assisted coiling of wide-necked intracranial aneurysms with a single microcatheter. BMC Neurol. 2019;19:245.CrossRef Park KY, Jang CK, Lee JW, Kim DJ, Kim BM, Chung J. Preliminary experience of stent-assisted coiling of wide-necked intracranial aneurysms with a single microcatheter. BMC Neurol. 2019;19:245.CrossRef
20.
Zurück zum Zitat Zhang X, Zhong J, Gao H, Xu F, Bambakidis NC. Endovascular treatment of intracranial aneurysms with the LVIS device: a systematic review. J Neurointerv Surg. 2017;9:553–7.CrossRef Zhang X, Zhong J, Gao H, Xu F, Bambakidis NC. Endovascular treatment of intracranial aneurysms with the LVIS device: a systematic review. J Neurointerv Surg. 2017;9:553–7.CrossRef
21.
Zurück zum Zitat Cagnazzo F, Cappucci M, Lefevre PH, Dargazanli C, Gascou G, Morganti R, Mazzotti V, di Carlo D, Perrini P, Mantilla D, Riquelme C, Bonafe A, Costalat V. Treatment of Intracranial Aneurysms with Self-Expandable Braided Stents: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2018;39:2064–9.CrossRef Cagnazzo F, Cappucci M, Lefevre PH, Dargazanli C, Gascou G, Morganti R, Mazzotti V, di Carlo D, Perrini P, Mantilla D, Riquelme C, Bonafe A, Costalat V. Treatment of Intracranial Aneurysms with Self-Expandable Braided Stents: A Systematic Review and Meta-Analysis. AJNR Am J Neuroradiol. 2018;39:2064–9.CrossRef
22.
Zurück zum Zitat Cagnazzo F, Limbucci N, Nappini S, Renieri L, Rosi A, Laiso A, Tiziano di Carlo D, Perrini P, Mangiafico S. Y-Stent-Assisted Coiling of Wide-Neck Bifurcation Intracranial Aneurysms: A Meta-Analysis. AJNR Am J Neuroradiol. 2019;40:122–8.CrossRef Cagnazzo F, Limbucci N, Nappini S, Renieri L, Rosi A, Laiso A, Tiziano di Carlo D, Perrini P, Mangiafico S. Y-Stent-Assisted Coiling of Wide-Neck Bifurcation Intracranial Aneurysms: A Meta-Analysis. AJNR Am J Neuroradiol. 2019;40:122–8.CrossRef
23.
Zurück zum Zitat Phan K, Huo YR, Jia F, Phan S, Rao PJ, Mobbs RJ, Mortimer AM. Meta-analysis of stent-assisted coiling versus coiling-only for the treatment of intracranial aneurysms. J Clin Neurosci. 2016;31:15–22.CrossRef Phan K, Huo YR, Jia F, Phan S, Rao PJ, Mobbs RJ, Mortimer AM. Meta-analysis of stent-assisted coiling versus coiling-only for the treatment of intracranial aneurysms. J Clin Neurosci. 2016;31:15–22.CrossRef
24.
Zurück zum Zitat Hong Y, Wang YJ, Deng Z, Wu Q, Zhang JM. Stent-assisted coiling versus coiling in treatment of intracranial aneurysm: a systematic review and meta-analysis. PLoS One. 2014;9:e82311.CrossRef Hong Y, Wang YJ, Deng Z, Wu Q, Zhang JM. Stent-assisted coiling versus coiling in treatment of intracranial aneurysm: a systematic review and meta-analysis. PLoS One. 2014;9:e82311.CrossRef
25.
Zurück zum Zitat King B, Vaziri S, Singla A, Fargen KM, Mocco J. Clinical and angiographic outcomes after stent-assisted coiling of cerebral aneurysms with Enterprise and Neuroform stents: a comparative analysis of the literature. J Neurointerv Surg. 2015;7:905–9.CrossRef King B, Vaziri S, Singla A, Fargen KM, Mocco J. Clinical and angiographic outcomes after stent-assisted coiling of cerebral aneurysms with Enterprise and Neuroform stents: a comparative analysis of the literature. J Neurointerv Surg. 2015;7:905–9.CrossRef
26.
Zurück zum Zitat Gross BA, Ares WJ, Ducruet AF, Jadhav AP, Jovin TG, Jankowitz BT. A clinical comparison of Atlas and LVIS Jr stent-assisted aneurysm coiling. J Neurointerv Surg. 2019;11:171–4.CrossRef Gross BA, Ares WJ, Ducruet AF, Jadhav AP, Jovin TG, Jankowitz BT. A clinical comparison of Atlas and LVIS Jr stent-assisted aneurysm coiling. J Neurointerv Surg. 2019;11:171–4.CrossRef
27.
Zurück zum Zitat Kim CH, Kim YH, Sung SK, Son DW, Song GS, Lee SW. Clinical Safety and Effectiveness of Stent-Assisted Coil Embolization with Neuroform Atlas Stent in Intracranial Aneurysm. J Korean Neurosurg Soc. 2020;63:80–8.CrossRef Kim CH, Kim YH, Sung SK, Son DW, Song GS, Lee SW. Clinical Safety and Effectiveness of Stent-Assisted Coil Embolization with Neuroform Atlas Stent in Intracranial Aneurysm. J Korean Neurosurg Soc. 2020;63:80–8.CrossRef
28.
Zurück zum Zitat Tsai JP, Hardman J, Moore NZ, Hussain MS, Bain MD, Rasmussen PA, Masaryk TJ, Elgabaly MH, Sheikhi L, Toth G. Early post-Humanitarian Device Exemption experience with the Neuroform Atlas stent. J Neurointerv Surg. 2019;11:1141–4.CrossRef Tsai JP, Hardman J, Moore NZ, Hussain MS, Bain MD, Rasmussen PA, Masaryk TJ, Elgabaly MH, Sheikhi L, Toth G. Early post-Humanitarian Device Exemption experience with the Neuroform Atlas stent. J Neurointerv Surg. 2019;11:1141–4.CrossRef
29.
Zurück zum Zitat Quintana EM, Valdes PV, Deza EM, García AG, Rodríguez MC, Pérez JMJ, Chaviano J, Morales JCG, Batista KP, García FA. Initial experience and one-year follow-up with Neuroform Atlas Stent System for the treatment of brain aneurysms. Interv Neuroradiol. 2019;25:521–9.CrossRef Quintana EM, Valdes PV, Deza EM, García AG, Rodríguez MC, Pérez JMJ, Chaviano J, Morales JCG, Batista KP, García FA. Initial experience and one-year follow-up with Neuroform Atlas Stent System for the treatment of brain aneurysms. Interv Neuroradiol. 2019;25:521–9.CrossRef
30.
Zurück zum Zitat Ten Brinck MFM, de Vries J, Bartels RHMA, Grotenhuis JA, Boogaarts HD. NeuroForm Atlas Stent-Assisted Coiling: Preliminary Results. Neurosurgery. 2019;84:179–89.CrossRef Ten Brinck MFM, de Vries J, Bartels RHMA, Grotenhuis JA, Boogaarts HD. NeuroForm Atlas Stent-Assisted Coiling: Preliminary Results. Neurosurgery. 2019;84:179–89.CrossRef
31.
Zurück zum Zitat Goertz L, Dorn F, Siebert E, Herzberg M, Borggrefe J, Schlamann M, Krischek B, Stavrinou P, Mpotsaris A, Bohner G, Liebig T, Kabbasch C. Safety and efficacy of the Neuroform Atlas for stent-assisted coiling of intracranial aneurysms: A multicenter experience. J Clin Neurosci. 2019;68:86–91.CrossRef Goertz L, Dorn F, Siebert E, Herzberg M, Borggrefe J, Schlamann M, Krischek B, Stavrinou P, Mpotsaris A, Bohner G, Liebig T, Kabbasch C. Safety and efficacy of the Neuroform Atlas for stent-assisted coiling of intracranial aneurysms: A multicenter experience. J Clin Neurosci. 2019;68:86–91.CrossRef
32.
Zurück zum Zitat Cay F, Peker A, Arat A. Stent-assisted coiling of cerebral aneurysms with the Neuroform Atlas stent. Interv Neuroradiol. 2018;24:263–9.CrossRef Cay F, Peker A, Arat A. Stent-assisted coiling of cerebral aneurysms with the Neuroform Atlas stent. Interv Neuroradiol. 2018;24:263–9.CrossRef
33.
Zurück zum Zitat Caragliano AA, Papa R, Pitrone A, Limbucci N, Nappini S, Ruggiero M, Visconti E, Alexandre A, Menozzi R, Lauretti D, Cavasin N, Alibrandi A, Tessitore A, Longo M, Vinci SL. The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms - immediate and midterm results: An Italian multicenter registry. J Neuroradiol. 2020;47:421–7. https://doi.org/10.1016/j.neurad.2019.03.005.CrossRefPubMed Caragliano AA, Papa R, Pitrone A, Limbucci N, Nappini S, Ruggiero M, Visconti E, Alexandre A, Menozzi R, Lauretti D, Cavasin N, Alibrandi A, Tessitore A, Longo M, Vinci SL. The low-profile Neuroform Atlas stent in the treatment of wide-necked intracranial aneurysms - immediate and midterm results: An Italian multicenter registry. J Neuroradiol. 2020;47:421–7. https://​doi.​org/​10.​1016/​j.​neurad.​2019.​03.​005.CrossRefPubMed
34.
Zurück zum Zitat Ulfert C, Pham M, Sonnberger M, Amaya F, Trenkler J, Bendszus M, Möhlenbruch MA. The Neuroform Atlas stent to assist coil embolization of intracranial aneurysms: a multicentre experience. J Neurointerv Surg. 2018;10:1192–6.CrossRef Ulfert C, Pham M, Sonnberger M, Amaya F, Trenkler J, Bendszus M, Möhlenbruch MA. The Neuroform Atlas stent to assist coil embolization of intracranial aneurysms: a multicentre experience. J Neurointerv Surg. 2018;10:1192–6.CrossRef
Metadaten
Titel
Safety and Efficacy of the Neuroform Atlas Stent for Treatment of Intracranial Aneurysms
A Systematic Review and Meta-Analysis
verfasst von
Jeremy Lynch
Sara Sciacca
Juveria Siddiqui
Lakshmi Kanagarajah
Shahram Derakhshani
Publikationsdatum
30.11.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Neuroradiology / Ausgabe 4/2021
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-020-00979-y

Weitere Artikel der Ausgabe 4/2021

Clinical Neuroradiology 4/2021 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.