Stent-Assisted Coiling Using Leo+ Baby Stent : Immediate and Mid-Term Results.

Abstract

BACKGROUND:

Stent-assisted coiling is well-established for treatment of cerebral aneurysms. The technique enables treatment of wide-neck, bifurcation and recurrent aneurysms with high packing rates. While described in extenso for laser cut stents, the results of patients treated with the Leo+ Baby (Balt, Montmorency, France) braided microstent are presented.

MATERIAL AND METHODS:

Patients were included if treated with a Leo+ Baby and with digital subtraction angiography (DSA) follow-up available of at least 6 months. Data were evaluated for successful deployment, aneurysm occlusion according to the modified Raymond-Roy classification (MRRC), stent patency and procedure-related morbidity and mortality.

RESULTS:

A total of 81 patients were included and Leo+ Baby deployment was successful in all cases. Coils were used in 80 cases. In 1 case 2 stents were used stent-in-stent without additional coiling. Initial aneurysm occlusion rates were MRRCi1 51.9%, MRRCi2 11.1%, MRRCi3a 24.7% and MRRCi3b 12.3%. Occlusion rates after 6 months were MRRC6m1 78.9%, MRRC6m2 3.9%, MRRC6m3a 6.6% and MRRC6m3b 10.5%. Procedure-related morbidity was 1 case of acute stent thrombosis successfully treated with tirofiban and 1 case with transient hemiparesis due to stent thrombosis after 4 months. There was 1 case of coil-associated subarachnoid hemorrhage (SAH) which caused prolonged hospitalization. No procedure-related mortality was observed.

CONCLUSION:

The results confirm that stent-assisted coiling with the Leo+ Baby stent is safe and efficient for treatment of wide neck or recurrent cerebral aneurysms. Spontaneous progressive aneurysm occlusion over 6 months supports the theory of considerable flow-modulating effects of Leo+ Baby.

• Authors: Hannes Luecking, Tobias Struffert, Philipp Goelitz, Tobias Engelhorn, Sebastian Brandner, Joji B Kuramatsu, Stefan Lang, Manuel Schmidt, Arnd Doerfler
• Journal: Clinical neuroradiology (Clin Neuroradiol) Vol. 31 Issue 2 Pg. 409-416 (Jun 2021) ISSN: 1869-1447 [Electronic] Germany
• PMID: 32385517 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Cerebral Angiography
• Embolization, Therapeutic
• Female
• Follow-Up Studies
• Humans
• Intracranial Aneurysm (diagnostic imaging, surgery)
• Male
• Middle Aged
• Retrospective Studies
• Stents
• Treatment Outcome
• Young Adult