Title:The Safety and Efficacy of Leo Stents with Coiling or Alone for Anterior Cerebral Artery Aneurysms
Volume: 20
Issue: 5
Author(s): Yu Duan*, Jun Shen*, Xuanfeng Qin, Binbin Xu, Renling Mao, Jian Li, Qinzhu An, Yujun Liao, Fayong Zhang and Gong Chen*
Affiliation:
- Department of Neurosurgery, Huadong Hospital, Fudan University, China
- Department of Neurology, Huadong
Hospital, Fudan University, China
- Department of Neurosurgery, Huashan Hospital, Fudan University,
Shanghai, China
Keywords:
Endovascular treatment, aneurysm, stent, coiling, artery, risk factor.
Abstract: Introduction: 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.
Methods: 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).
Results: 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.
Conclusions: 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.
