The introduction of low-profile stent systems has broadened and facilitated the treatment of complex intracranial aneurysms. This retrospective case series study was conducted to assess and compare the clinical and angiographic outcomes of patients with complex intracranial aneurysms who were treated with ACCLINO® (AS) and ACCLINO® flex stents (AFS).
In 85 patients (female 61; male 24) a total of 95 complex intracranial aneurysms, 71 (74.7%) in the anterior circulation and 24 (25.3%) in the posterior circulation were treated. Angiographic and clinical data, aneurysm characteristics and follow-up results were analyzed.
The AS was used in 47 cases (49.5%) and the AFS in 48 cases (50.5%). Initial angiography after the intervention showed a complete occlusion in 52.6% (Raymond-Roy occlusion classification [RROC] 1), a neck remnant in 38.9% (RROC 2) and an incomplete occlusion in 8.4% (RROC 3). Follow-up (AS: 25.2 ± 15.4 months; AFS: 9.6 ± 8.0 months) revealed an occlusion rate of 70.5% (RROC 1), 27.4% (RROC 2) and 2.1% (RROC 3). There was no statistically significant difference between the initial (p = 0.484) and the follow-up occlusion rate (p = 0.284) when comparing the two devices. Recoiling was performed in 8 cases (8.4%). The overall complication rate was 9.5% with 5 strokes (5.3%), 2 hemorrhages (2.1%), 1 in-stent stenosis (1.1%), 1 stent occlusion (1.1%) and 2 stent thromboses (2.1%). There was no procedure-related mortality.
Using the ACCLINO® and ACCLINO® flex stent system is a feasible and effective procedure with an acceptable safety profile. Initial and follow-up angiographic results were satisfactory.
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ACCLINO® flex stent
Low-profile visualized intraluminal support
Middle cerebral artery
Magnetic resonance imaging
Posterior inferior cerebellar artery
Raymond-Roy occlusion classification
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This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Conflict of interest
P. Dietrich, A. Gravius, R. Mühl-Benninghaus, U. Yilmaz, M. Kettner, H. Bomberg, W. Reith and A. Simgen declare that they have no competing interests.
All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the institutional and/or national research committee and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. Additional written informed consent was obtained from all individual participants or their legal representatives for whom identifying information is included in this article. Ethics committee approval was obtained (identification number 203/18).
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Dietrich, P., Gravius, A., Mühl-Benninghaus, R. et al. Single Center Experience in Stent-Assisted Coiling of Complex Intracranial Aneurysms Using Low-Profile Stents. Clin Neuroradiol (2020). https://doi.org/10.1007/s00062-020-00883-5