Single-center experience in the endovascular treatment of wide-necked intracranial aneurysms with a bridging intra-/extra-aneurysm implant (pCONus)

J Neurointerv Surg. 2016 Nov;8(11):1186-1191. doi: 10.1136/neurintsurg-2015-012004. Epub 2015 Dec 9.

Abstract

Purpose: To retrospectively evaluate the safety and efficacy of the endovascular treatment of wide-necked intracranial aneurysms assisted by a novel intra-/extra-aneurysm stent-like implant (pCONus).

Methods: Initial and follow-up angiographic and clinical results are presented of 25 patients with 25 unruptured and ruptured wide-necked intracranial aneurysms treated by reconstruction of the aneurysm neck using the pCONus implant followed by coil occlusion of the fundus.

Results: Successful intra-/extra-aneurysm deployment of the pCONus with coil occlusion of the fundus was achieved in all but one case. Procedure-related ischemic complications were observed in three cases with permanent deterioration in one. Acceptable aneurysm occlusion was achieved in all cases. Follow-up angiography revealed sufficient occlusion in 81.0% of the aneurysms. Intimal hyperplasia in the stented segment of the parent artery or device migration has not been observed to date.

Conclusions: The pCONus device offers a promising treatment option for complex wide-necked bifurcation intracranial aneurysms. Acute or delayed dislocations of coils into the parent artery are successfully avoided.

Keywords: Aneurysm; Coil; Device; Intervention; Stent.

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / surgery
  • Cerebral Angiography / methods
  • Embolization, Therapeutic / instrumentation
  • Embolization, Therapeutic / methods
  • Endovascular Procedures / instrumentation
  • Endovascular Procedures / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidental Findings
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents*
  • Treatment Outcome