ArticleQuantitative imaging in medicine and surgery2026
Feasibility of vault configuration of the Neuroform Atlas stent in the treatment of bifurcation intracranial aneurysm: clinical observation and hemodynamic simulation.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Coil prolapse and stent-induced vascular deformation during single stent-assisted coiling (SSAC) of bifurcation intracranial aneurysms (BIAs) may compromise branch vessel patency. The vault configuration achieved via the Neuroform Atlas stent (NAS) is a clinically observed deployment pattern that may contribute to aneurysm neck coverage while maintaining branch vessel patency; however, its morphological and hemodynamic characteristics remain insufficiently characterized. This study aimed to provide a preliminary quantitative description of vault configuration. Methods: This retrospective study included 35 BIAs treated with single NAS-assisted coiling. Vascular morphological characteristics were evaluated via digital subtraction angiography (DSA) at pretreatment, posttreatment, and follow-up time points. In addition, patient-specific virtual stenting and computational fluid dynamics (CFD) simulations were performed in six cases (with seven protected branch vessels) for quantitative characterization of the branch-protective efficacy conferred by the vault. Results: All branch vessels protected by the vault configuration remained patent during follow-up. No significant differences were observed in vessel diameters or vascular angles across pretreatment, posttreatment, or follow-up imaging (all P values >0.05). Hemodynamic analysis showed that branch-flow responses varied across anatomical configurations. In exploratory simulations, six of seven simulated branches demonstrated smaller flow reductions in the vault models than in the corresponding no-vault models, with a mean branch-flow reduction 5.12% lower than that observed in the no-vault models; however, the magnitude of the differences varied considerably across cases. Conclusions: The vault configuration of the Neuroform Atlas appears to be a technically feasible deployment pattern in selected cases and was associated with preserved branch-vessel patency in this cohort. Virtual deployment and CFD analyses suggested that vault-associated flow alterations may vary according to local vascular anatomy. However, the observed hemodynamic findings should be considered exploratory and hypothesis-generating, and further validation in larger cohorts is needed.
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