The Safety and Efficacy of Leo Stents with Coiling or Alone for Anterior Cerebral Artery Aneurysms

• Published in: Current neurovascular research Vol. 20; no. 5; p. 560
• Main Authors: Duan, Yu, Shen, Jun, Qin, Xuanfeng, Xu, Binbin, Mao, Renling, Li, Jian, An, Qinzhu, Liao, Yujun, Zhang, Fayong, Chen, Gong
• Format: Journal Article
• Language: English
• Published: United Arab Emirates 2024
• Subjects: Adult; Aged; Anterior Cerebral Artery - diagnostic imaging; Anterior Cerebral Artery - surgery; Cerebral Angiography; Embolization, Therapeutic - instrumentation; Embolization, Therapeutic - methods; Endovascular Procedures - adverse effects; Endovascular Procedures - instrumentation; Endovascular Procedures - methods; Female; Humans; Intracranial Aneurysm - diagnostic imaging; Intracranial Aneurysm - surgery; Intracranial Aneurysm - therapy; Male; Middle Aged; Retrospective Studies; Stents - adverse effects; Treatment Outcome; stent; aneurysm; artery; Endovascular treatment; risk factor; coiling
• DOI: 10.2174/0115672026271147231130111233

Treatment of anterior cerebral artery (ACA) aneurysms is still not well established. The Leo stent with blood flow direction is a retrievable stent for intracranial aneurysms, whereas it needs to be studied clearly in patients with ACA aneurysms. Consecutive patients with ACA aneurysms were retrospectively enrolled in three neurosurgical centers between January 2016 and October 2021. The data on demographics, aneurysm characteristics, symptom resolution, and postoperative course were collected and analyzed. The aneurysm occlusion status was appraised by Raymond-Ray Occlusion Class (RROC). A total of 57 patients with ACA aneurysms were included in our study. Immediate postprocedural angiograms showed that 20 aneurysms (35.1%) were in complete occlusion (RROC 1), 26 aneurysms (45.6%) were in near-complete occlusion (RROC 2), 11 aneurysms (19.3%) were in incomplete occlusion (RROC 3). The angiographic follow-up found that the rate of complete occlusion increased to 57.9%, and near-completion and incomplete occlusion dropped to 29.8% and 12.3%, respectively. The angiographic result of the last follow-up improved significantly (Z=- 2.805, P=0.005). Univariate analysis indicated that distal location of aneurysms (Z=4.538, P=0.033) and ruptured aneurysms (χ2=.6120, P=0.032) were potential risk factors for intra-parent artery narrowing. Furthermore, multivariate logistic regression analysis found that A3 aneurysms (95% CI 1.427~32.744, P=0.016) are the key risk factor for intra-parent artery narrowing. The Leo stent is safe and effective for aneurysms located in ACA circulations. The overall occlusion degree improved during follow-up. A distal, small artery was the risk factor for intra-parent artery narrowing.