The pCONus2 Neck-Bridging Device: Early Clinical Experience and Immediate Angiographic Results

World Neurosurg. 2018 Feb:110:e766-e775. doi: 10.1016/j.wneu.2017.11.097. Epub 2017 Nov 24.

Abstract

Background: Treating wide-necked aneurysms is challenging for the interventional neuroradiologist. Recently, numerous devices dedicated to the treatment of these aneurysms have become available. We report our early experience using the pCONus2 device and present the technical success rate, clinical outcomes, and immediate angiographic occlusion rates.

Methods: We performed a retrospective review of prospectively collected data to identify patients treated with the pCONus2 device between February 2015 and February 2017.

Results: We identified 12 patients (10 females) treated with the pCONus2 device. The average patient age was 56.6 ± 15.8 years (range, 13-71 years). The average aneurysm dome width was 8.83 ± 5.3 mm (range, 3.8-20 mm), the average dome height was 7.23 ± 4.06 mm (range, 3.36-15 mm), and the average neck width was 5.88 ± 2.92 mm (range, 2.77-11 mm). The angulation of the aneurysm to the parent vessel varied between 0 and 78° (mean, 32.2°). Ten aneurysms were located in the anterior circulation, and 2 were in the posterior circulation. Immediate posttreatment angiography showed 11 aneurysms with modified Raymond-Roy classification (mRRC) grade I occlusion and 1 aneurysm with mRRC grade II occlusion. There were no deaths or hemorrhagic complications. Three patients developed small thrombi during treatment, all of whom were successfully treated with glycoprotein IIb/IIIa antagonists. Early angiographic follow-up data for 6 patients showed adequate aneurysm occlusion in 5 patients and aneurysm recanalization in 1 patient.

Conclusions: The early results on the use of the pCONus2 device suggest that it can be useful for treating wide-necked aneurysms; however, larger studies with longer-term follow-up data are needed.

Keywords: Aneurysm; Bifurcation; Neck bridging; Stent; Wide neck; pCONus 2.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cerebral Angiography*
  • Equipment Design
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Prospective Studies
  • Retrospective Studies
  • Stents*
  • Treatment Outcome
  • Young Adult