BACKGROUND: Stent-assisted coiling (SAC) is an effective, safe, and durable treatment option when considering embolizing wide neck aneurysms. While there are many techniques, the two most common involve jailing a microcatheter behind the stent versus re-crossing the interstices. Despite both techniques being performed in practice, there is a lack of comparison data. This study uses the ATLAS Investigational Device Exemption trial to compare the safety and efficacy of various SAC techniques.

METHODS: A total of 298 aneurysms in as many patients were treated in 25 centers with Neuroform Atlas SAC. Technique choice was determined by the operator and involved jailing, re-crossing, or others (jailing followed by re-crossing, stenting followed by re-crossing at a different time). Patient demographics, aneurysm shape, dimension, and location, as well as the number of coils and procedure duration, were analyzed. Procedure and device complications of the different techniques were recorded. Efficacy was evaluated with a core-lab adjudicated 12-month digital subtraction angiography (DSA).

RESULTS: Similar aneurysm size and location were observed between the two groups (jailing and re-crossing). There was no significant difference in the number of coils used or the duration of the procedure. There was no significant difference in Raymond-Roy I occlusion rate (89.4% vs 83.9%) at the 12-month DSA or safety events at 12 months.

CONCLUSION: There were no significant differences in safety or efficacy for SAC between the jailing or re-crossing technique.