Paul Emile Labeyrie1, Benjamin Gory2, Marta Aguilar-Perez3, Elisa Pomero4, Alessandra Biondi4, Roberto Riva2, Francis Turjman2, Hans Henkes3. 1. Department of Interventional Neuroradiology, Neurologic Hospital Pierre Wertheimer, Hospices Civil de Lyon, Lyon, France. Electronic address: Labeyriepaulemile@gmail.com. 2. Department of Interventional Neuroradiology, Neurologic Hospital Pierre Wertheimer, Hospices Civil de Lyon, Lyon, France. 3. Department of Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany. 4. Department of Neuroradiology and Endovascular Therapy, Jean-Minjoz Hospital, Franche-Comté University, Besançon, France.
Abstract
BACKGROUND AND PURPOSE: Anterior communicating artery (AcomA) aneurysms with a wide neck are often not feasible for endovascular coiling. Emerging devices for neck protection, such as the pCONus stent, are promising for endovascular treatment of challenging intracranial aneurysms. We report the preliminary results with pCONus in the treatment of wide-neck AcomA aneurysms. METHODS: All consecutive patients harboring AcomA aneurysms treated with pCONus in 3 European centers were retrospectively reviewed. RESULTS: Thirty-six patients (mean age, 61 years) harboring 36 saccular AcomA aneurysms (mean dome size, 7.3 mm; mean neck size, 5.4 mm) were included, of which 7 were treated in the setting of subarachnoid hemorrhage. A procedural angiographic complication was reported in 3 patients without clinical impact at 3 months. Five patients presented a postoperative neurological deficit without angiographic complication. Procedure-related permanent morbidity and mortality rates were 11% (3/33) and 0 at 3 months, respectively. Postoperative angiographic results showed a complete aneurysm occlusion in 56% (20/36), a neck remnant in 25% (9/36), and an aneurysm remnant in 19% (7/36) of cases. Four patients were retreated after early angiographic follow-up (mean, 3.2 months). Twenty-two patients were followed (mean, 12.9 months), and a complete aneurysm occlusion was observed in 59% of patients (13/22), and a neck remnant in 41% (9/22). There was no in-stent stenosis or jailed branch occlusion. Recanalization rate was 9%. CONCLUSIONS: The pCONus device allows endovascular coiling of wide-necked AcomA aneurysms.
BACKGROUND AND PURPOSE: Anterior communicating artery (AcomA) aneurysms with a wide neck are often not feasible for endovascular coiling. Emerging devices for neck protection, such as the pCONus stent, are promising for endovascular treatment of challenging intracranial aneurysms. We report the preliminary results with pCONus in the treatment of wide-neck AcomA aneurysms. METHODS: All consecutive patients harboring AcomA aneurysms treated with pCONus in 3 European centers were retrospectively reviewed. RESULTS: Thirty-six patients (mean age, 61 years) harboring 36 saccular AcomA aneurysms (mean dome size, 7.3 mm; mean neck size, 5.4 mm) were included, of which 7 were treated in the setting of subarachnoid hemorrhage. A procedural angiographic complication was reported in 3 patients without clinical impact at 3 months. Five patients presented a postoperative neurological deficit without angiographic complication. Procedure-related permanent morbidity and mortality rates were 11% (3/33) and 0 at 3 months, respectively. Postoperative angiographic results showed a complete aneurysm occlusion in 56% (20/36), a neck remnant in 25% (9/36), and an aneurysm remnant in 19% (7/36) of cases. Four patients were retreated after early angiographic follow-up (mean, 3.2 months). Twenty-two patients were followed (mean, 12.9 months), and a complete aneurysm occlusion was observed in 59% of patients (13/22), and a neck remnant in 41% (9/22). There was no in-stent stenosis or jailed branch occlusion. Recanalization rate was 9%. CONCLUSIONS: The pCONus device allows endovascular coiling of wide-necked AcomA aneurysms.
Authors: Thomas J Sorenson; Marta Iacobucci; Mohammad H Murad; Laurent Spelle; Jacques Moret; Giuseppe Lanzino Journal: Surg Neurol Int Date: 2019-02-28
Authors: Marta Aguilar Pérez; Hans Henkes; Wiebke Kurre; Carlos Bleise; Pedro Nicolás Lylyk; Javier Lundquist; Francis Turjman; Hanan Alhazmi; Christian Loehr; Stephan Felber; Hannes Deutschmann; Stephan Lowens; Luigi Delehaye; Markus Möhlenbruch; Jörg Hattingen; Pedro Lylyk Journal: J Clin Med Date: 2022-02-08 Impact factor: 4.241
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