Clinical safety and efficacy of stent-assisted coil embolization with ACCERO stent in cerebral aneurysm: Short-term follow-up and precaution for use.

Abstract

Objective: Stent-assisted coil embolization (SAC) is an effective method of treating intracranial aneurysms. The aim of the study was to assess the safety and efficacy of the new ACCERO stent for the treatment of cerebral aneurysms.

Methods: It was a retrospective, single-center study. Nine ruptured and 41 unruptured cerebral aneurysms were treated using the ACCERO stent between February 2021 and December 2023. Patient demographics, aneurysm characteristics, procedural parameters, grade of occlusion, complications, and clinical outcomes were analyzed. Follow-up was conducted with magnetic resonance angiography (MRA) or Digital subtraction angiography (DSA) was performed 6 to 12 months after the procedure.

Results: The ACCERO stent deployment was attempted in 51 cases, with replacement by the Neuroform Atlas stent in 1 case. Successful stent deployment was achieved in 50 cases, and appropriate wall apposition to the parent artery. The average clinical follow-up period was 17.1 months. Intimal hyperplasia was observed in 1 case, but no other clinical complications related to the stent occurred. Favorable clinical outcomes were observed in 92% of patients (46/50), including those with subarachnoid hemorrhage. Immediate favorable angiographic outcomes and complete occlusion were achieved in 90% (45/50) and 74% (37/50) of cases, respectively. Among the 45 patients who had imaging follow-up, favorable angiographic outcomes and complete occlusion were observed in 93.3% (43/45) and 82.2% (37/45) of cases, respectively.

Conclusions: The ACCERO stent is a braided-type stent that requires more attention than stents, such as the Neuroform Atlas or Enterprise stents. However, since the struts of the stent are fully visible, it can be more useful in treating challenging aneurysms once the user becomes familiar with its use.