Single-Center Experience of Cerecyte Coils in the Treatment of Intracranial Aneurysms: Initial Experience and Early Follow-Up Results

Introduction: Flow diverter embolization is a novel method to treat intracranial aneurysms. The device has been shown to reduce procedure time and radiation exposure along with excellent long-term occlusion rates for single lesions. However, the effect of flow diversion on multiple adjacent aneurysms has not been well studied. We present our single center experience with flow diverter treatment of tandem aneurysms. Methods: We retrospectively collected clinical, imaging, procedural and follow up data on patients in whom flow diverters were used to treat intracranial anterior circulation aneurysms between 2011 and 2016. We included patients who had 2 or more tandem aneurysms of the internal carotid artery segment and where flow diverter was intended to treat all the aneurysms either as primary or secondary method. Results: We identified 21 patients with 52 aneurysms that met inclusion criteria. All were females with median age of 57 (Interquartile range [IQR] 51 - 69). Seventeen patients had 2 adjacent aneurysms, while 4 patients had 3 contiguous aneurysms. Of these, only one patient was treated acutely for ruptured aneurysm. The median largest aneurysm diameter was 3.1mm (IQR 2.5 - 4.8) with most common locations being cavernous and ophthalmic aneurysms. In 19 patients (90.5%) only a single flow diverter stent was used; only one patient required concurrent coiling. One patient (4.8%) suffered a post procedural mild stroke but improved rapidly. There were no other procedural complications. Follow up data in 13 patients (61.9%) with a median follow up of 8 months (IQR 6 - 13) demonstrated that 20 out of 28 aneurysms showed complete occlusion (71.4%). None of the patients at follow up required re-treatment, and there were no delayed/late aneurysm ruptures. Conclusion: Flow diverter is a feasible, efficacious and safe treatment option in patients with multiple tandem aneurysms, in a single session with good early outcomes. Long term follow up data and large cohort studies are required.

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Endovascular treatment of medium and large intracranial aneurysms with large volume coils: A single-center experience

Surgical Neurology International ◽

10.25259/sni_947_2021 ◽

2022 ◽

Vol 13 ◽

pp. 9

Author(s):

Giancarlo Saal-Zapata ◽

Basavaraj Ghodke ◽

Melanie Walker ◽

Ivethe Pregúntegui-Loayza ◽

Rodolfo Rodríguez-Varela

Keyword(s):

Endovascular Treatment ◽

Clinical Outcomes ◽

Large Volume ◽

Intracranial Aneurysms ◽

Intraoperative Complications ◽

Complication Rates ◽

Single Center ◽

Single Center Experience ◽

The Mean

Background: Large volume coils are an alternative to conventional coils for the treatment of intracranial aneurysms. However, there are no published reports documenting occlusion and complication rates in medium and large intracranial aneurysms. Therefore, we present our results in this subgroup of aneurysms. Methods: A single-center, retrospective analysis of consecutive patients treated with Penumbra coils 400 in aneurysms ≥7 mm was performed. Demographics, aneurysm features, procedural details, intraoperative complications, clinical outcomes, and occlusion rates were analyzed. Results: Thirty-three patients were included for analysis, and a total of 33 intracranial aneurysms were analyzed. Mean age was 57.6 years (SD ± 12.4) and 85% of the patients were women. Large aneurysms represented 46% of cases. Paraclinoid (55%) followed by posterior communicating (30.3%) aneurysms was the most frequently treated. Ruptured and saccular aneurysms were found in 49% and 63% of the cases, respectively. The mean aneurysmal dimensions were 14.2 mm width, 11.9 mm length, 5.4 mm neck, and 2.4 dome-to-neck ratio. A dome-neck ratio <2 was identified in 39% of cases. The mean number of coils per aneurysm was 4.8. Immediate modified Raymond–Roy Grades 1, 2, and 3A were achieved in 15%, 21%, and 64%, respectively. Twenty-six patients were evaluated at a mean follow-up period of 11 months, with an adequate occlusion of 92% and a good clinical outcome (modified Rankin score ≤2) in 96% of patients. Conclusion: Endovascular treatment with PC400 coils is an effective and safe option for medium and large intracranial aneurysms with high occlusion rates, few complications, and good clinical outcomes at follow-up.

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Low-Profile Neuroform Atlas Stent-Assisted Coiling of Intracranial Aneurysms: Single-Center Initial Experience

Journal of Clinical Interventional Radiology ISVIR ◽

10.1055/s-0039-1685243 ◽

2019 ◽

Vol 03 (02) ◽

pp. 117-121 ◽

Cited By ~ 1

Author(s):

Somnath Pan ◽

Santhosh Kumar Kannath ◽

Jayadevan Enakshy Rajan

Keyword(s):

Intracranial Aneurysms ◽

Initial Experience ◽

Single Center ◽

Complete Occlusion ◽

New Device ◽

Low Profile ◽

Ruptured Intracranial Aneurysm ◽

Class 1 ◽

Minimal Residual

Abstract Background Neuroform Atlas stent is a relatively new device used for stent-assisted coiling (SAC) of wide-necked intracranial aneurysms. Purpose To elaborate the initial experience in a single center to assess the efficacy and initial results of Neuroform Atlas for SAC of intracranial aneurysms. Methods Between February 2017 and September 2018, eight patients (five females, three males; mean age 56 years) underwent SAC with Neuroform Atlas. Results Five unruptured and three ruptured wide-necked aneurysms were treated with Neuroform Atlas SAC. Immediate complete occlusion modified Roy-Raymond class 1 (MRRC 1) or mild neck residue class 2 (MRRC 2) was achieved in three patients and five other patients had minimal residual interstitial filling of the aneurysm (MRRC 3b). One patient with ruptured intracranial aneurysm succumbed to the illness in the first postoperative day due to massive rebleed. Other seven patients remained clinically asymptomatic in the follow-up period. Patent stent was noted at three to seven months follow-up magnetic resonance angiography (MRA) in five patients. Complete occlusion of the aneurysm was noted in three patients, and minimal residual aneurysm was seen in two patients. Conclusion Neuroform Atlas stent is safe and effective in achieving good angiographic outcome in complex intracranial aneurysms.

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