Early experience with a temporary bridging device (Comaneci) in the endovascular treatment of ruptured wide neck aneurysms

J Neurointerv Surg. 2018 Oct;10(10):978-982. doi: 10.1136/neurintsurg-2017-013641. Epub 2018 Feb 6.

Abstract

Background: The difficulties in obtaining complete and stable endovascular occlusion are most evident for ruptured aneurysms exhibiting a wide neck and unfavorable geometric features. The aim of our study was to present our experience with the Comaneci temporary bridging device in ruptured wide neck aneurysms.

Methods: From May to July 2017, 29 ruptured aneurysms underwent endovascular embolization with the Comaneci device. Angiographic and clinical results were retrospectively analyzed.

Results: 29 ruptured intracranial aneurysms from different locations were included. Successful embolization was achieved in all lesions; complete post-procedure occlusion was seen in 25 (86%) cases. Insufficient embolization or neck remnant was observed in four cases (13.7%). Complications probably related, directly related, or indirectly related to the device occurred in 3.44% of patients (1/29 patients). At least one angiographic follow-up was performed in each of the 29 cases. The 12 month follow-up examination has yet to be done.

Conclusion: The Comaneci device offers a new promising and reliable technique that can safely support aneurysm coiling occlusion even in a rupture environment. However, long term monitoring of patients treated by this device is mandatory.

Keywords: aneurysm; device; hemorrhage; subarachnoid.

MeSH terms

  • Adult
  • Aged
  • Aneurysm, Ruptured / diagnostic imaging*
  • Aneurysm, Ruptured / surgery*
  • Blood Vessel Prosthesis
  • Embolization, Therapeutic / methods
  • Endovascular Procedures / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / surgery*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Stents
  • Treatment Outcome