Comparative analysis of Neuroform Atlas and Enterprise 2 stents in stent-assisted coiling for anterior circulation aneurysms: a propensity score-matched study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: Stent-assisted coiling (SAC) is widely used for wide-necked intracranial aneurysms. Limited studies have compared new generation Neuroform Atlas and Enterprise 2 (EP2) stents. This study compared the two in terms of efficacy, safety, and cost implications. Methods: Data from 572 patients with anterior circulation aneurysms treated with SAC using either Atlas or EP2 stents were retrospectively analyzed. Propensity score matching (PSM) was applied to balance patient and aneurysm characteristics between the groups. Results: The Atlas group had a higher prevalence of male patients, smokers, drinkers, hypertensives, and distal carotid artery aneurysms. The dome-to-neck ratio was larger in the EP2 group. After PSM (147 matched pairs), there were no significant differences in occlusion rates (89.1% vs. 87.1%, P=0.719), perioperative ischemic (6.8% vs. 10.2%, P=0.403) and hemorrhagic complications (2.0% vs. 2.0%, P=0.999), or favorable outcomes (98.6% vs. 96.6%, P=0.444). The EP2 stent was associated with lower hospital costs ($25,235.9±6,484.2 vs. $27,540.5±7125.9, P=0.004). Subgroup analysis revealed that the Atlas group had more advantages in preventing ischemic complications for bifurcation aneurysms, aneurysms with smaller parent vessel diameter, and aneurysms with larger dome-to-neck ratio; but these differences were not significant after PSM. Conclusions: Atlas and EP2 stents are effective for anterior circulation aneurysms. EP2 stent offers economic benefits, whereas Atlas stent was more commonly used for aneurysms with smaller parent artery diameters and bifurcation aneurysms and ischemic complications were less frequent with the Neuroform Atlas compared to EP2 in these aneurysm types.
Authors: Qichen Peng, Linggen Dong, Yangyang Zhou, Chao Wang, Lin Zhu, Xuanping Xie, Xiaoxi Zhu, Kaiyu Liu, Yisen Zhang, Ming Lv, Wenqiang Li, Shiqing Mu
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415655867
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