Abstract
Background The Neuroform Atlas Stent System is an established treatment modality for unruptured anterior and posterior circulation intracranial aneurysms. Location-specific results are needed to guide treatment decision- making. However, it is unclear whether there are differences in safety and efficacy outcomes between carotid and more distal anterior circulation aneurysms. Methods The ATLAS IDE trial was a prospective, multicenter, single- arm, open-label interventional study that evaluated the safety and efficacy of the Neuroform Atlas Stent System. We compared differences in efficacy and safety outcomes of proximal internal carotid artery (ICA) versus distal and bifurcation anterior circulation aneurysms.
Results Of 182 cases, there were 70 aneurysms in the ICA and 112 in the distal anterior circulation (including ICA terminus/bifurcation). There were no significant differences in the primary efficacy endpoint (85.5% vs 83.9%, p=0.78) and complete aneurysm occlusion rates (88.7% vs 87.9%, p=0.78) between proximal ICA aneurysms and distal aneurysms, respectively. Complications were more often encountered in distal and bifurcation aneurysms, but the overall rate of major safety events was low and comparable between the two groups (1.4% vs 6.3%, p=0.14). Recanalization and retreatment rates were also similar between the groups. Conclusion The results of this study suggest that the Neuroform Atlas Stent System is a safe and efficacious treatment modality for unruptured anterior circulation intracranial aneurysms, regardless of aneurysm location.
Document Type
Article
Publication Date
2024
Digital Object Identifier (DOI)
https://doi.org/10.1136/jnis-2023-020591
Funding Information
The ATLAS trial (Safety and Effectiveness of the Treatment of Wide Neck, Saccular Intracranial Aneurysms with the Neuroform Atlas Stent System) was funded by Stryker Neurovascular.
Repository Citation
Hanel, Ricardo A.; Cortez, Gustavo M.; Jankowitz, Brian T.; Sauvageau, Eric; Aghaebrahim, Amin; Lin, Eugene; Jadhav, Ashutosh P.; Gross, Bradley; Khaldi, Ahmad; Gupta, Rishi; Frei, Donald; Loy, David; Price, Lori Lyn; Hetts, Steven W.; Zaidat, Osama O.; and ATLAS Investigators, "Anterior circulation location-specific results for stent- assisted coiling – carotid versus distal aneurysms: 1- year outcomes from the Neuroform Atlas Stent Pivotal Trial" (2024). Neurology Faculty Publications. 113.
https://uknowledge.uky.edu/neurology_facpub/113
Notes/Citation Information
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.