Preliminary outcomes of Neuroform Atlas stent-assisted coiling for intracranial aneurysms with small parent vessels.

Background: Although stent-assisted coiling has become a standard approach for treating intracranial aneurysms (IAs), there are limited reports on its safety and effectiveness in parent artery less than 2.5 mm in diameter. This study evaluates the feasibility, safety, and short-term outcomes of using Neuroform Atlas stent-assisted coiling for IAs with small parent vessels.

Methods: This study reviewed and analyzed the clinical data of 50 IAs in 50 patients with a parent artery diameter of ≤ 2.5 mm, treated with Neuroform Atlas stent-assisted coiling at a single center between November 2020 and April 2024. Immediate postoperative angiographic outcomes were assessed using the modified Raymond-Roy classification. Follow-up imaging included computed tomographic angiography (CTA), magnetic resonance angiography (MRA), and digital subtraction angiography (DSA). Clinical outcomes were evaluated using the modified Rankin Scale (mRS).

Results: The procedures achieved a 100% success rate. Immediately after treatment, 24 cases were classified as Raymond-Roy grade I, 11 as grade II, and 15 as grade III. Follow-up angiography in 28 cases revealed three instances of aneurysm recurrence, with a secondary procedure performed in one case. One patient reported poor neurological status, and two cases experienced procedure-related adverse events during telephone or clinical follow-up. Conclusions the Atlas stent demonstrated favorable outcomes in the treatment of aneurysms in small parent arteries (< 2.5 mm), with a low complication rate. The timely postoperative use of tirofiban may further reduce the risk of ischemic complications.