Initial experience of coiling cerebral aneurysms using the new Comaneci device

Object The authors present a retrospective analysis of their initial experience with the recently developed MicroVention HydroCoil to treat patients with cerebral aneurysms. Unlike the bare metal coils initially available for endovascular treatment of aneurysms, HydroCoils have a layer of hydrogel polymer surrounding a platinum metallic core. The hydrogel polymer expands soon after making contact with blood. The expanded hydrogel polymer provides increased volumetric filling compared with bare metal coils and offers a more biocompatible surface, as demonstrated in animal models. Methods Over a 17-month period, the authors used HydroCoils to treat 30 patients with 33 aneurysms. All patients had been treated at least 6 months prior to data analysis. Initial treatment results as well as records of clinical and angiographic follow up were reviewed. Six-month posttreatment angiograms were available for 25 patients. Conclusions The HydroCoils were implanted with few complications. On angiographic follow up, a clearly defined radiolucent separation of the coils from the parent artery was noted in many of the aneurysms treated. The authors have not previously observed angiographically demonstrated lucencies separating the coils from the parent artery. This frequent, but not consistent, appearance on follow-up angiograms obtained in this study indicates that HydroCoils support significant neointimal formation across the neck of treated aneurysms. The preliminary results indicate that HydroCoils can be used safely and effectively to treat aneurysms and that these devices may allow for improved aneurysm filling.

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Initial Experience of a Novel Sheath Guide for Transbrachial Coil Embolization of Cerebral Aneurysms in the Anterior Cerebral Circulation

Operative Neurosurgery ◽

10.1227/neu.0b013e31826e2cd9 ◽

2012 ◽

Vol 72 (1) ◽

pp. ons15-ons20 ◽

Cited By ~ 2

Author(s):

Tomonori Iwata ◽

Takahisa Mori ◽

Hiroyuki Tajiri ◽

Yuichi Miyazaki ◽

Masahito Nakazaki ◽

...

Keyword(s):

Coil Embolization ◽

Cerebral Circulation ◽

Cerebral Aneurysms ◽

Initial Experience ◽

Aortic Diseases ◽

Transfemoral Approach ◽

Femoral Route ◽

Common Technique ◽

Procedural Success ◽

Guiding Catheter

Abstract Background: The transfemoral approach is a common technique for coil embolization of cerebral aneurysms in the anterior cerebral circulation. However, it is difficult to advance a guiding catheter into the carotid artery via the femoral route in patients with a tortuous aortic arch, an unfavorable supra-aortic takeoff, aortic diseases, or occlusion of the femoral artery. Objective: To report our initial experiences of coil embolization of cerebral aneurysms in the anterior cerebral circulation with a novel sheath guide for transbrachial carotid cannulation. Methods: A sheath guide designed specifically for transbrachial carotid cannulation was developed; transbrachial coil embolization for cerebral aneurysms began in May 2011. Included for analysis were patients who underwent transbrachial coil embolization for cerebral aneurysms in the anterior cerebral circulation from May 2011 to January 2012. Adjuvant techniques, angiographic results, procedural success, and periprocedural complications were investigated. Results: Ten patients underwent transbrachial coil embolization of cerebral aneurysms in the anterior cerebral circulation. All procedures were successful using the brachial route. No periprocedural complications occurred. Patients were permitted to get seated immediately after coil embolization even during hemostasis. Conclusion: The sheath guide specifically designed for transbrachial carotid cannulation was useful for coil embolization of cerebral aneurysms in the anterior cerebral circulation.

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p64 Flow Modulation Device in the treatment of intracranial aneurysms: initial experience and technical aspects

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2015-011743 ◽

2015 ◽

Vol 8 (2) ◽

pp. 173-180 ◽

Cited By ~ 22

Author(s):

Francesco Briganti ◽

Giuseppe Leone ◽

Mariano Marseglia ◽

Domenico Cicala ◽

Ferdinando Caranci ◽

...

Keyword(s):

Endovascular Treatment ◽

Intracranial Aneurysms ◽

Cerebral Aneurysms ◽

Aneurysm Rupture ◽

Safe Procedure ◽

Initial Experience ◽

Flow Modulation ◽

New Device ◽

Technical Complications

BackgroundExperience with the endovascular treatment of cerebral aneurysms by flow diverter devices (FDDs) is limited to four devices (Pipeline, Covidien; FRED, Microvention; Silk, Balt Extrusion; Surpass, Stryker), as reported in different studies.ObjectiveTo describe the initial experience and the technical innovations of a new-generation FDD (p64 Flow Modulation Device, Phenox, Bochum, Germany).MethodsBetween December 2014 and February 2015, six intracranial aneurysms in five patients (four women, one man; mean age 63 years) were treated with the p64 Flow Modulation Device.ResultsImmediate post-treatment angiography showed reduced flow into all aneurysms. No long-term angiographic data are available. The device may be easily deployed and totally retrieved with a unique mechanical detachment. No periprocedural technical complications occurred. No early or delayed aneurysm rupture, no ischemic or hemorrhagic complications, and no neurological morbidity or death were seen.ConclusionsTreatment of cerebral aneurysms with the p64 Flow Modulation Device is a safe procedure with no technical complications. The mechanical detachment and the 100% retrievability are significant advantages of this new device. However, large prospective studies with long-term clinical and angiographic follow-up are necessary to assess the role of the p64 in the endovascular treatment of intracranial aneurysms.

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