Neuroform Atlas Stenting for Parent Arteries Spanning the 2-mm Threshold: A Multicenter Propensity Score–Matched Analysis

OBJECTIVE: To compare the efficacy and safety of the Neuroform Atlas stent-assisted coiling of intracranial aneurysms arising from parent arteries <2.0 mm (SPAD) versus ≥ 2.0 mm (LPAD). METHODS: This retrospective study included 687 aneurysms treated at three centers from January 2020 to December 2024. Propensity scores were used for 1:1 nearest-neighbor matching without replacement, yielding 96 pairs. RESULTS: The cohort included 139 SPAD and 548 LPAD aneurysms. Clinical and imaging follow-up were available for 624 and 419 aneurysms, respectively; median follow-up was 6 months in both groups with no significant differences between the SPAD and LPAD groups. After matching, no statistically significant differences were observed in follow-up complete occlusion rate, recurrence rate and ischemic or hemorrhagic events (all P>0.05). CONCLUSION: This study showed exploratory observations on safety and efficacy of using Neuroform Atlas stenting by the 2.0-mm threshold. No statistically differences were observed between the 2.0-mm threshold.