Neuroform Atlas single-stent coiling for wide-neck MCA bifurcation aneurysms: a retrospective single-centre case series

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Background Wide-neck aneurysms at the middle cerebral artery (MCA) bifurcation pose a recognized challenge for endovascular treatment. Y- or X-stent configurations can reconstruct the bifurcation but increase procedural complexity and complication risk. The Neuroform Atlas is a low-profile, open-cell stent that allows single-stent neck reconstruction through 0.0165-inch microcatheters. Evidence on its performance in Chinese patients remains limited. Methods We conducted a retrospective, single-centre case series of 15 consecutive patients with wide-neck MCA bifurcation aneurysms treated with Neuroform Atlas stent-assisted coiling at the Aviation General Hospital (Beijing, China) between October 2023 and February 2025. Inclusion criteria were aneurysm neck >4 ​mm or dome-to-neck ratio <1.5, age 18–75 years and ability to comply with follow-up; both ruptured (Hunt–Hess I–III) and unruptured aneurysms were included. Fourteen aneurysms were treated with a single stent and one required Y-stenting. The primary endpoint was complete occlusion (Raymond grade I) at 6-month angiographic follow-up; secondary endpoints included periprocedural thromboembolic or haemorrhagic events, functional outcome measured by the modified Rankin Scale (mRS) and the need for retreatment. Data were summarised descriptively. Results Patients had a median age of 61 years (range 30–75 years) and were predominantly female (73 ​%). Aneurysms had a median neck width of 4.2 ​mm and mean maximum diameter of 5.16 ​mm; 40 ​% presented with subarachnoid haemorrhage. Technical success was 100 ​%, with 14/15 aneurysms treated using a single stent. Immediate or follow-up angiography showed Raymond grade I occlusion in all cases. No periprocedural thromboembolic or haemorrhagic events were observed, all patients achieved mRS ≤2 ​at last follow-up, and no recurrences or retreatments were required. Conclusions In this small retrospective series, Neuroform Atlas single-stent-assisted coiling was feasible and achieved complete occlusion with no procedure-related complications in wide-neck MCA bifurcation aneurysms. These preliminary results suggest the approach may offer a safe and effective alternative to complex dual-stenting techniques, but larger prospective studies with control groups are needed to confirm its generalizability.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.