To evaluate the safety and efficacy of LEO Baby stent-assisted coiling in the treatment of wide-neck intracranial aneurysms.

Between December 2018 to June 2019, 21 patients with wide-neck intracranial aneurysms were treated with LEO Baby stent-assisted coiling at Department of Cerebrovascular Disease, Zhengzhou University People′s Hospital and retrospectively enrolled into this study. There were 23 aneurysms in those 21 patients. Among them, 5 aneurysms were located on the anterior communicating artery, 10 at the bifurcation of middle cerebral artery, 2 at the M1 segment of middle cerebral artery, 3 at the M2 segment of middle cerebral artery and 3 at the A3 segment of the anterior cerebral artery. The ratio of neck/dome was more than 1/2 in all intracranial aneurysms. Single LEO Baby stent-assisted coiling was used in 22 aneurysms, and the other aneurysms was treated with the Y stent technique (LEO Baby + Neuroform EZ). After the procedure, the immediate DSA was performed to evaluate the aneurysm occlusion and the parent artery patency. The clinical follow-up was performed in all patients for 3 months post discharge. The modified Rankin Scale (mRS) score was used to determine the patient′s outcome and the mRS ≤2 was defined as good outcome. After 6 to 8 months, DSA was performed to evaluate the aneurysm occlusion and stent patency.

A total of 21 patients with 23 aneurysms were all successfully treated. The immediate postprocedural Raymond scale of the aneurysms were assessed which indicated grade Ⅰ in 18 aneurysms (78.3%), Ⅱ in 3 (13.0%) and Ⅲ in 2 (8.7%). The periprocedural complications rate was 9.5% (2/21). Out of the 2 patients with complications, 1 died of severe pulmonary infection, and the other developed cerebral infarction due to the late-onset cerebral vasospasm and the mRS score was 3 at discharge. Twenty patients obtained 3-month clinical follow-up post procedure, and the mRS scores were 1 in 1 patient, 2 in 1 and 0 in the remaining 18. All patients had good outcomes (mRS≤2). Sixteen patients with 17 aneurysms obtained the imaging follow-up lasing for 6.4±0.7 months (range: 6-8 months) post procedure. Of those, 15 aneurysms were Raymond Ⅰ immediately post procedure indicating complete embolization, and the other 2 were Raymond Ⅱ and Ⅲ respectively immediately post surgery, none of which showed any further growth in the tumor neck and dome. No in-stent stenosis or delayed thromboembolic events were noted in 17 patients.

This preliminary study has suggested that LEO Baby stent-assisted coiling seems safe and effective in the embolization of intracranial aneurysms on small-diameter arteries, which can be used as an option for treatment of aneurysms at intracranial bifurcation or far ends of arteries.

Intracranial aneurysm; Embolization, therapetic; Treatment outcome; Wide neck; LEO Baby stent