Evaluating Efficacy and Complications of Contour Intrasaccular Device in Cerebral Aneurysm Management: A Multicenter Analysis

World Neurosurg. 2024 Mar:183:e738-e746. doi: 10.1016/j.wneu.2024.01.017. Epub 2024 Jan 7.

Abstract

Background: Intrasaccular devices provide a method for treating complex aneurysms without leaving metallic materials in the parent artery. Compared to other well-studied devices in neurointervention, the Contour device is relatively new as an intrasaccular flow diverter. This study examines its use in cases of incidental aneurysms and its application in the acute treatment of ruptured aneurysms. Additionally, it covers potential complications that may arise and methods for prevention.

Methods: We conducted a retrospective analysis of 25 patients who underwent treatment with the Contour device at 3 hospital centers. We collected data related to age, gender, baseline modified Rankin Scale, personal habits, medical history, procedure details, and angiographic results according to the Woven endobridge occlusion scale.

Results: A total of 15 patients (65.5%) achieved a satisfactory angiographic result (grade 0-0') 1 year after embolization. Contrast stagnation was observed in 14 patients (58.3%). Intraprocedural complications, such as device displacement, were documented in 3 patients (12%), while 2 patients (8%) had aggregates attached to the device. Regarding late complications, 5 patients (20%) experienced device displacement and 1 patient had a minor stroke (4%). Retreatment was necessary for 3 patients (12%), involving a flow diverter, stenting, and coiling.

Conclusions: In summary, the Contour device offers a viable option for treating complex aneurysms. While initial results are promising, it is crucial to acknowledge a learning curve to minimize complications and achieve satisfactory angiographic results without the need for additional treatments.

Keywords: Aneurysm; Contour; Disruptor; Flow; Intrasaccular.

Publication types

  • Multicenter Study

MeSH terms

  • Aneurysm, Ruptured* / diagnostic imaging
  • Aneurysm, Ruptured* / surgery
  • Cerebral Angiography
  • Embolization, Therapeutic* / methods
  • Endovascular Procedures* / methods
  • Humans
  • Intracranial Aneurysm* / diagnostic imaging
  • Intracranial Aneurysm* / surgery
  • Retrospective Studies
  • Stents
  • Treatment Outcome