Hospital readmission among patients with unruptured intracranial aneurysms undergoing stent-assisted endovascular coiling using the ENTERPRISE ® 2 stent versus Neuroform ® Atlas stent

Aim: Stent-assisted endovascular coiling is a safe and effective treatment for unruptured intracranial aneurysms (UIAs). This study compared 180-day inpatient readmission and cost among patients with UIA who underwent stent-assisted coiling (SAC) using the ENTERPRISE ® 2 or Neuroform ® Atlas stent. Materials & methods: In this retrospective cohort study, adults with UIA undergoing SAC were identified in the Premier Healthcare Database (2016–2022) and grouped based on the stent used: ENTERPRISE 2 or Neuroform Atlas. Outcomes included all-cause and UIA-related inpatient readmission in the 180 days following treatment, index admission and supply cost. Inverse probability of treatment weighting of propensity score method balanced the two cohorts on study covariates. A weighted generalized estimating equation model assessed study outcomes. Results: A total of 1017 patients were included (ENTERPRISE 2, n = 126; Neuroform Atlas, n = 891). Hospital and patient characteristics except race were well-balanced after weighting. Patients treated with ENTERPRISE 2 versus Neuroform Atlas were 55% less likely to have an all-cause inpatient readmission in the 180-day follow-up period (odds ratio 0.45, 95% CI: 0.20–0.98, p = 0.04). Further, the ENTERPRISE 2 cohort had significantly lower index supply cost ($20,442 vs $27,561, exponentiated ratio 0.74, 95% CI: 0.61–0.90, p = 0.002) compared with the Neuroform Atlas cohort. No significant differences were observed in UIA-related inpatient readmission or total index admission cost between cohorts. Conclusion: Among patients with UIA undergoing SAC, the use of ENTERPRISE 2 stent was associated with a significantly reduced risk of all-cause inpatient hospital readmission and significantly lower index supply cost compared with the Neuroform Atlas stent.