Initial Clinical Experience with a New Self-Expanding Nitinol Microstent for the Treatment of Wide-Neck Intracranial Cerebral Aneurysms: the Acandis Acclino Stent

Abstract

Background and Purpose—The Acclino is a laser-cut closed-cell microstent composed of nitinol. It
was developed for stent-assisted coiling of wide-neck intracranial aneurysms. The key feature of the stent is
its deployability via low-profile microcatheters with an inner diameter of 0.0165 inch, which are also suited
for coil deployment. The objective of this study was to evaluate the safety and feasibility as well as the
immediate and mid-term results of this new device.
Materials and Methods—Our database was screened for all Acclino-based stent-assisted intracranial
coil embolizations since its introduction to the European market in June 2012. Case files and imaging data
were retrospectively analyzed for angiographical and clinical outcome parameters, including immediate
and mid-term modified Raymond-Roy aneurysm occlusion classification (RROC) rates and procedural
complications.
Results—Fourteen patients comprising 14 aneurysms (9 unruptured and 5 ruptured) were treated with the
Acclino. All except for a dissecting one were wide-neck saccular aneurysms. Immediate complete occlusion (RROC1) was observed in 8/14 cases (57%), a residual neck (RROC2) in 4/14 (29%), and a persistent
filling of the dome (RROC 3) in 1/14 cases (7%). An in-stent thrombus formation in one case (7%) was
medically resolved without neurological deficit. Follow-up was available in 9/14 cases (64%) after a mean
of 137 days (SD ± 50). All followed cases depicted a complete occlusion (RROC1).
Conclusions—The Acclino microstent showed a satisfactory safety profile and a promising rate of
immediate and mid-term complete aneurysm occlusion for stent-assisted coil embolization in wide-neck
intracranial aneurysms, warranting further investigation of the device