Safety and effect of Neuroform Atlas stent in the treatment of symptomatic intracranial stenosis: A single-center experience

Background: Vascular intracranial stenosis (IS) is a significant cause of acute ischemic stroke (AIS). This single center study aims to show that symptomatic IS treatment by using the Neuroform Atlas stent (Stryker neurovascular, Kalamazoo, MI, USA) could be effective in reducing vessel stenosis. Methods: Ten patients affected by AIS or TIA, in the vascular territory of high-grade intracranial atherosclerotic lesions (>70% of vessel stenosis), older than 18-year-old, were treated by implanting a Neuroform Atlas stent (diameter of 4.5mm in 80% and 4mm in 20%). 70% of the patients underwent pre-stenting intracranial angioplasty. Results: Patients were between 54.8 and 83 years old (mean 68.46y +/- 8.44y), 70% males and 30% females. At admission, 50% of all patients had an AIS and 50% a TIA. Restoration of the stenotic lumen was obtained after the endovascular procedure. The percentage mean of vascular stenosis was 83.7% +/- 6.09% before treatment (t0), 52.2% +/- 10.42% at the end of treatment (t1) and 46.2% +/- 8.28% at the follow-up (t2). The IS percentage mean reduction between t0 and t1 was 31.5% +/- 7.31%, and between t1 and t2 was 6% +/- 5.47%, t0 and t2 of 37.5% +/- 7.38%. Percentage reduction of IS was highly significant between time t0 and t1 (p = 0.005), and t0 and t2 (p = 0.005), also with a significant reduction between t1 and t2 (p = 0.012). No patient had experienced an increase of the ischemic area in the vascular territory of the target vessel at 3 months from the initial assessment. 10% of patients experienced a 3-months negative outcome (mRS = 5), 90% experienced a favorable outcome (mRS <2). Conclusions: Intracranial stenosis endovascular treatment with Neuroform Atlas stent provides encouraging results, with a statistically significant association between the vascular caliber improvement and the endovascular treatment.