Alejandro Tomasello1,2, David Hernandez1,2, Laura Ludovica Gramegna2,3, Sonia Aixut4, Roger Barranco Pons4, Olav Jansen5, Michal Zawadzki6, Antonio Lopez-Rueda7, Carmen Parra-Fariñas2, Carlos Piñana1, Lavinia Dinia1,2, Fuat Arikan8, Alex Rovira2,9. 1. 1Interventional Neuroradiology Section, Department of Radiology, Vall d'Hebron University Hospital, Barcelona. 2. 2Vall d'Hebron Research Institute (VHIR), Vall d'Hebron University Hospital, Barcelona, Spain. 3. 3IRCCS Istituto delle Scienze Neurologiche di Bologna, Italy. 4. 4Department of Neuroradiology, Hospital Universitari de Bellvitge de Llobregat, Barcelona, Spain. 5. 5Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany. 6. 6Division of Interventional Neuroradiology, Department of Radiology, Centre of Postgraduate Medical Education, Warsaw, Poland. 7. 7Department of Radiology, Hospital Clinic I Provincial de Barcelona. 8. 8Department of Neurosurgery, Vall d'Hebron University Hospital, and Neurotraumatology and Neurosurgery Research Unit (UNINN), Vall d'Hebron Research Institute, Barcelona; and. 9. 9Section of Neuroradiology and Magnetic Resonance Unit, Vall d'Hebron University Hospital, Barcelona, Spain.
Abstract
OBJECTIVE: The goal of this study was to evaluate the effectiveness and safety of a new noncompletely occlusive net-assisted remodeling technique in which the Cascade net device is used for temporary bridging of intracranial aneurysms. METHODS: Between July 2018 and May 2019, patients underwent coil embolization with the Cascade net device within 4 centers in Europe. Analysis of angiographic (modified Raymond-Roy classification [MRRC]) and clinical outcomes data was conducted immediately following treatment and at the 6-month follow-up. RESULTS: Fifteen patients were included in the study (mean age 58 ± 13 years, 11/15 [73.3%] female). Ten patients had unruptured aneurysms, and 5 presented with ruptured aneurysms with acute subarachnoid hemorrhage. The mean aneurysm dome length was 6.27 ± 2.33 mm and the mean neck width was 3.64 ± 1.19 mm. Immediately postprocedure, MRRC type I (complete obliteration) was achieved in 11 patients (73.3%), whereas a type II (residual neck) was achieved in 4 patients (26.7%). Follow-up examination was performed in 7/15 patients and showed stabilization of aneurysm closure with no thromboembolic complications and only 1 patient with an increased MRRC score (from I to II) due to coil compression. CONCLUSIONS: Initial experience shows that the use of a new noncompletely occlusive net-assisted remodeling technique with the Cascade net device may be safe and effective for endovascular coil embolization of intracranial aneurysms.
OBJECTIVE: The goal of this study was to evaluate the effectiveness and safety of a new noncompletely occlusive net-assisted remodeling technique in which the Cascade net device is used for temporary bridging of intracranial aneurysms. METHODS: Between July 2018 and May 2019, patients underwent coil embolization with the Cascade net device within 4 centers in Europe. Analysis of angiographic (modified Raymond-Roy classification [MRRC]) and clinical outcomes data was conducted immediately following treatment and at the 6-month follow-up. RESULTS: Fifteen patients were included in the study (mean age 58 ± 13 years, 11/15 [73.3%] female). Ten patients had unruptured aneurysms, and 5 presented with ruptured aneurysms with acute subarachnoid hemorrhage. The mean aneurysm dome length was 6.27 ± 2.33 mm and the mean neck width was 3.64 ± 1.19 mm. Immediately postprocedure, MRRC type I (complete obliteration) was achieved in 11 patients (73.3%), whereas a type II (residual neck) was achieved in 4 patients (26.7%). Follow-up examination was performed in 7/15 patients and showed stabilization of aneurysm closure with no thromboembolic complications and only 1 patient with an increased MRRC score (from I to II) due to coil compression. CONCLUSIONS: Initial experience shows that the use of a new noncompletely occlusive net-assisted remodeling technique with the Cascade net device may be safe and effective for endovascular coil embolization of intracranial aneurysms.