Efficacy and safety of the Neuroform Atlas stent for bifurcation type unruptured cerebral aneurysms: Comparison of single versus Y stents with propensity score matching - 21/08/25
, Toshihiro Ishibashi b, Kazufumi Horiuchi a, Akihiko Teshigawara a, Ken Aoki c, Issei Kan b, Toshihide Tanaka b, Yuichi Murayama bHighlights |
• | This is the first study to compare the efficacy and safety of Y-stent assisted coiling (Y-SAC) and single-stent assisted coiling (S-SAC). |
• | Y-SAC significantly increased the complete occlusion rate and packing density immediately after treatment compared with S-SAC. |
• | No significant differences in the incidences of any complications were found between the Y-SAC and S-SAC. |
• | There were no significant differences in the recanalization rates and the rate of complete occlusion one year after treatment between the Y-SAC and S-SAC. |
Graphical abstract |
Abstract |
Background and Purpose |
Y-stent-assisted coiling (Y-SAC) using two stents can provide adequate coverage of the aneurysm neck even in wide-neck bifurcation-type aneurysms, but whether it is more effective and safer than single-stent-assisted coiling (S-SAC) remains unclear. The purpose of this study was to investigate the efficacy and safety of Y-SAC with the Neuroform Atlas stent for bifurcation-type unruptured cerebral aneurysms (UCAs).
Materials and Methods |
A total of 186 bifurcation-type UCAs treated with the Neuroform Atlas stent were retrospectively reviewed. The aneurysms were divided into Y-SAC and S-SAC groups. Angiographic occlusion status and complication rates were analyzed using 1:2 propensity score matching.
Results |
Of the 186 UCAs, 17 (9.1 %) were treated by Y-SAC. Propensity score matching was successful for 14 UCAs in the Y-SAC group and 28 UCAs in the S-SAC group. After propensity score matching, the Y-SAC group had a higher rate of complete occlusion immediately after treatment (71.4 % vs. 32.1 %, P = 0.023), a significantly higher volume embolization ratio (33.3 % [IQR: 30.4, 38.5] vs. 28.9 % [IQR: 24.1, 32.4], P = 0.03), and higher device and implant costs ($11,335 [IQR: $10,427, $13,894] vs. $9592 [IQR: $8211, $10,959], P = 0.002) compared to the S-SAC group. However, the rate of complete occlusion at one year (78.6 % vs. 64.3 %, P = 0.485) and the recanalization rate (14.3 % vs. 3.6 %, P = 0.254) did not differ significantly between the two groups. No significant differences in the incidences of any complications were found between the two groups.
Conclusions |
Y-SAC did not improve the complete occlusion rate at one year or reduce the risk of recanalization compared with S-SAC. Given its procedural simplicity and cost-effectiveness, S-SAC may be the preferred strategy for embolizing bifurcation-type UCAs.
Le texte complet de cet article est disponible en PDF.Keywords : Complete occlusion, Device cost, Implant cost, Recanalization, Unruptured intracranial aneurysm, Y-stent-assisted coiling
Abbreviations : ACoA, BA, DSA, IQR, MCA, PCA, RROC, S-SAC, UCAs, VER, Y-SAC
Plan
Vol 52 - N° 5
Article 101369- septembre 2025 Retour au numéro
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