Y-stent-assisted coiling with Neuroform Atlas stents for wide-necked intracranial bifurcation aneurysms: A preliminary report

OBJECTIVE: To report our experience on Neuroform Atlas Y-stenting for coiling of unruptured wide-neck bifurcation aneurysms. METHODS: From March 2018 to January 2021, we treated 473 aneurysms in 436 patients with coil embolization, of which 15 cases with wide-necked bifurcation aneurysms were treated by Y-stent-assisted coiling with two Neuroform Atlas stents. We retrospectively reviewed the characteristics of patients and aneurysms, procedure-related complications, radiographic results, and clinical outcomes. RESULTS: All 15 cases using Neuroform Atlas Y-stenting were successful. Patients included 6 men and 9 women with a mean age ± standard deviation of 56.4±6.6 years. The mean dome and neck sizes were 6.4±3.1 mm and 4.7±1.8 mm, respectively. Immediate post-procedural angiograms showed complete occlusion in 46.7%, neck remnant in 13.3%, and incomplete occlusion in 40% of cases. No treatment-related morbidity or mortality occurred in any patients. All patients had good clinical outcomes (Glasgow Outcome Score 5) at both discharge and during a mean 12.3-month (range 1-28 months) follow-up. All aneurysms showed improved or stable occlusion on follow-up imaging. Further, the latest follow-up angiography showed complete occlusion in 73.3%, neck remnant in 6.7%, and incomplete occlusion in 20%. CONCLUSIONS: Y-stent-assisted coiling with Neuroform Atlas stents might be a feasible and safe option for wide-necked bifurcation aneurysms.