Safety and efficacy of stent-assisted coiling of unruptured distal anterior cerebral artery aneurysms with low-profile braided stents.

Aim: Distal anterior cerebral artery (ACA) aneurysms are a rare and difficult entity to manage. In this single-centre retrospective case series, we aimed to investigate the safety and efficacy of LEO Baby stent-assisted coiling (SAC) for the treatment of unruptured distal ACA aneurysms.

Material And Methods: This retrospective study aims to identify patients with unruptured distal ACA aneurysms treated with LEO Baby stent-assisted coiling in a single institution from October 2018 to October 2022. We assessed the immediate and follow-up aneurysm occlusion rates, procedure-related complications, and clinical outcomes.

Results: A total of 20 patients with 21 aneurysms were identified. Technical success was achieved in all cases. The immediate angiography showed complete occlusion in 14 aneurysms (66.7%), neck remnants in 6 (28.6%), and residual sac in 1 (4.8%). Procedure-related ischaemic complications occurred in 2 cases (10%), with one patient leaving mild contralateral low extremity weakness. Six-month follow-up angiography was achieved in 15 (71.4%) aneurysms, which showed complete occlusion in all 15 aneurysms. Clinical follow-up was available in all patients with a median duration of 18.8 ± 10.19 months, and all patients had a favourable clinical outcome (modified Rankin Scale score: 0-2).

Conclusion: This study demonstrates that stent-assisted coiling of intracranial aneurysms located on distal ACA with LEO Baby stents is technically feasible, highly effective, and has midterm durability in aneurysmal occlusion.