Preliminary Use of the Leo Stent in the Endovascular Treatment of Wide-necked Cerebral Aneurysms

BackgroundCurrently available stents for intracranial use usually are Neuroform (Boston Scientific/Target, Fremont, CA) and Leo (Balt, Montmorency, France) stents. We present the results of our initial experience in using the Leo stent to treat patients with wide-necked cerebral aneurysms.MethodsFifteen consecutive patients with wide-necked intracranial aneurysm were treated with a combined approach that consisted of delivery of a flexible self-expending neurovascular stent through a microcatheter to cover the neck of the aneurysm and subsequent filling of the aneurym with coils through the stent interstices. We assessed the clinical history, aneurysm dimensions, and technical details of the procedures, including any difficulties with stent deployment, degree of aneurysm occlusion, and complications.ResultsDuring a 1-year period, 15 patients with 17 broad-necked aneurysms (n = 13; average neck length, 5.1 mm; average aneruysm size, 9 mm) were treated with the Leo stent. Fifteen stents were deployed successfully; two failed. Of the coiled aneurysms, complete or subtotal (more than 95%) occlusion was achieved in 11 aneurysms, and partial occlusion was achieved in 2 aneurysms. One patient had multiple stents placed. One patient had a ruptured aneurysm at the time of treatment. Technical problems included difficulty in deploying the stent (n = 2). Two periprocedural thromboembolic complications occurred. One patient had palsy after thrombolysis was attempted. The other patient made an excellent functional recovery after undergoing successful thrombolysis of a thrombosed internal carotid artery stent.ConclusionsPreliminary data demonstrated that the Leo stent is useful device for the treatment of patients with wide-necked aneurysms. In cases with tortuous cerebral vasculature, delivery and deployment may be technically challenging. Clinically significant complications are uncommon.