Wingspan Stent System
Self-expandable stents have broadened the spectrum of endovascular treatment of intracranial aneurysms. However, procedures involving double stenting in Y/X configurations carry a relatively high risk of procedural complications.
The Neuroform ATLAS, the evolution of Neuroform EZ, is a nitinol self-expanding hybrid/open cell stent which can be delivered through a low profile 0.017-inch catheter. Ciccio et al. presented the experience in the treatment of intracranial aneurysms with this stent in Y and X configurations.
They prospectively maintained a database from consecutive patients who underwent double stent-assisted coiling with the Neuroform ATLAS, from July 2015 to February 2019. Clinical and angiographic results were analyzed.
55 patients harboring 55 bifurcation aneurysms were treated with double stenting: 52 ‘Y’ configurations, 3 ‘X’ configurations. Deployment was successful in all cases. Post-treatment control angiography showed complete occlusion in 33 cases (60%), neck remnant in 8 cases (14.5%), and incomplete occlusion in 14 cases (25.4%). The overall symptomatic periprocedural complication rate was 12.7%. 38 aneurysms underwent follow-up (69%, mean duration 16 months): 33 aneurysms (87%) were completely occluded, 3 aneurysms (8%) had a neck remnant, and 2 aneurysms (5%) were incompletely occluded.
The Neuroform ATLAS is an effective device for the treatment of bifurcation aneurysms, allowing good conformability, a high level of navigability, and easy mesh crossing to perform Y/X stenting procedures. The rate of procedural complications remains non-negligible, and an indication for a double stenting procedure should be carefully discussed in a multidisciplinary meeting 1).
Neuroform EZ® Stent System
This stents manufactured by Boston Scientific for Stryker Neurovascular.
Flexible Design – Enhanced Delivery Introducing the industry leading self-expandable and conformable stent design with a simplified delivery system. By reducing stent delivery to three steps – Access, Advance, Deploy – enhanced control meets efficiency.
Used for stentassisted coiling of wide necked aneurysm.
The Neuroform stent seems to be safe and technically effective in the endovascular management of distal cervical and intracranial dissections, with favorable clinical outcomes 2).