Long term results of wide-necked intracranial bifurcation aneurysms treated with stent-assisted coiling using low-profile acandis acclino stents

The stent-assisted coiling technique was developed to enable endovascular treatment of bifurcation aneurysms
and aneurysms with an unfavourable dome-to-neck ratio, previously uncoilable. The aneurysmal recurrence rate compared to sole coiling was reduced.’

Several different flexible self-expanding stents were introduced over the last years and clinically
used for the treatment of those complex intracranial aneurysms.”

The design of low profile self-expandable stents such as LVIS Jr. (MicroVention, Tustin, California), LEO baby (Balt, Montmorency, France), and Acclino (Acandis, Pforzheim, Germany) enables the deployment in small arteries and the delivery through microcatheters. The ongoing evolution of these stent system with improved features and a broader spectrum of stent diameters further increased the technical possibilities of minimally invasive intracranial aneurysm treatment.

Risks of thrombosis, stent luxation and in-stent stenosis increase with the method of stent-assisted coiling compared to sole coiling.? Hence, long-term follow-up is essential to evaluate the safety and effectiveness and compare the different stent systems.*

Acclino stents were introduced in 2012 as the second generation of low-profile closed-cell Acandis stents. The newest, fourth generation of Acclino stents was introduced in 2016, the Acclino flex plus stent. Only a few
studies have described the initial clinical experiences and follow-up results with Acclino stents in the treatment
of intracranial aneurysms in small cohorts.°-‘° However, as far as we know, they focus on the second and third generations and are limited to short-term or mid-term results.

This retrospective study included all generations of Acclino stents used for stent-assisted coiling with single and multiple stenting, including the kissing-Y stenting technique.” We analysed the safety and effectiveness and evaluated the long-term results of 57 complex intracranial aneurysms treated with these stent systems.

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