Comparison of clinical outcomes after stent-assisted coiling with three types of self-expanding laser-cut stents in patients with wide-necked intracranial aneurysms.

ABSTRACT Objective We report the clinical outcomes of stent-assisted coiling for wide-necked intracranial aneurysms using three low-profile laser-cut stents and compare the results according to stent type. Methods All patients treated with stent-assisted coiling for their intracranial aneurysms at our hospital between July 2010 and September 2019 were reviewed. We selected patients with Enterprise, Neuroform EZ, or Neuroform Atlas stents who underwent imaging follow-up and investigated aneurysm and stent features, stent-related complications, recanalization and retreatment rates. We compared the retreatment risk among the patients treated with the three stent types using Kaplan-Meier survival analysis and Cox regression analysis. Results We evaluated 364 consecutive cases (103 Enterprise, 105 Neuroform EZ, and 156 Neuroform Atlas stents). Neuroform Atlas was more frequently used in distal vessels: 8 (7.8%) Enterprise, 2 (1.9%) Neuroform EZ, and 41 (26.3%) Neuroform Atlas cases, respectively. The median follow-up durations were 6.49, 4.91, and 1.24 years for the Enterprise, Neuroform EZ, and Neuroform Atlas cases, respectively, and retreatment was performed in 11 (10.1%), 9 (8.6%) and 6 (3.8%) cases. In the first two years of follow-up, the estimated retreatment risk ratios for Neuroform EZ and Neuroform Atlas with Enterprise as reference were 0.63 (95% CI, 0.24–1.65; p=0.35) and 0.54 (95% CI, 0.18–1.59; p=0.26), respectively. Conclusion Neuroform Atlas stents were more frequently deployed in small caliber vessels compared with the other two types of stents. The complication rate and retreatment risk until at least one year after the aneurysm treatment appeared to be similar for the three stent types.