Complex Wide-necked and Lobulated Aneurysm of the Middle Cerebral Artery Bifurcation

Sirakov, Alexander; Aguilar-Pérez, Marta; AlMatter, Muhammad; Henkes, Hans

doi:10.1007/s00062-019-00862-5

Cited by 4 publications

(1 citation statement)

References 24 publications

(25 reference statements)

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“…Compared with other devices, pCONus devices were popularly used, including pCONus 1, pCONus 2, pCONus 2 HPC, and pCANvas devices. The pCONus devices are stent-like self-expanding nitinol implants that blossom like a flower inside the aneurysm to facilitate the "waffle-cone technique" (88)(89)(90)(91)(92). Some reports have shown that the use of a pCONus device to assist in coiling of MCA aneurysms successfully treats more than 95% of cases and achieves adequate aneurysm occlusion in more than 80% of cases, such as in Ulfert et al 's report (93), in the pToWin trial (94), in Morales-Caba et al 's report (91), and in Yeomans et al 's report (92).…”

Section: Pconus Devicementioning

confidence: 99%

Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects

Zhou,

Lan,

2023

Front. Neurol.

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Middle cerebral artery (MCA) aneurysms are complex and widely distributed throughout the course of the MCA. Various types of aneurysms can occur in the MCA. Ruptured as well as unruptured MCA aneurysms may require treatment to avoid bleeding or rebleeding. Currently, clipping is regarded as the first-line choice for the treatment of MCA aneurysms. However, endovascular treatment (EVT) is emerging as an alternative treatment in selected cases. EVT techniques vary. Therefore, it is necessary to review EVT for MCA aneurysms. In this review, the following issues were discussed: MCA anatomy and anomalies, classifications of MCA aneurysms, the natural history of MCA aneurysms, EVT status and principle, deployments of traditional coiling techniques and flow diverters (FDs), and deployments and prospects of intrasaccular flow disruptors and stent-like devices. According to the review and our experience, traditional coiling EVT is still the preferred therapy for most MCA aneurysms. FD deployment can be used in selective MCA aneurysms. Parent artery occlusion (PAO) can be used to treat distal MCA aneurysms. In addition, new devices can be used to treat MCA aneurysms, such as intrasaccular flow disruptors and stent-like devices. In general, EVT is gaining popularity as an alternative treatment option; however, there is still a lack of evidence regarding EVT, and longer-term data are not currently available for most EVT devices.

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Section: Pconus Devicementioning

confidence: 99%

Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects

Zhou,

Lan,

2023

Front. Neurol.

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Comaneci plus Balloon-assisted Embolization of Ruptured Wide-necked Cerebral Aneurysms

et al. 2022

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The pCONUS2 and pCONUS2 HPC Neck Bridging Devices

et al. 2022

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Introduction Bifurcation aneurysms represent an ongoing endovascular challenge with a variety of techniques and devices designed to address them. We present our multicenter series of the pCONUS2 and pCONUS2 HPC devices when treating bifurcation aneurysms. Methods We performed a retrospective review of our prospectively maintained databases at 3 tertiary neurointerventional centers to identify all patients who underwent coil embolization with the pCONUS2 or pCONUS2 HPC device between February 2015 and August 2021. We recorded baseline demographics, aneurysm data, complications, immediate and delayed angiographic results. Results We identified 55 patients with 56 aneurysms, median age 63 years (range 42–78 years), 67.3% female (n = 37). The commonest aneurysm location was the MCA bifurcation (n = 40, 71.4%). Average dome height was 8.9 ± 4.2 mm (range 3.2–21.5 mm), average neck width 6.4 ± 2.5 mm (range 2.6–14 mm), and average aspect ratio 1.3 ± 0.6 (range 0.5–3.3). The pCONUS2 was used in 64.3% and the pCONUS2 HPC in 35.7%. The procedural technical success rate was 98.2%. Intraoperative complications occurred in 5 cases (8.9%), 4 of which were related to the coils with partial thrombus formation on the pCONUS2 HPC seen in 1 case that was resolved with heparin. In relation to the procedure and treatment of the aneurysm the overall permanent morbidity was 1.8% (n = 1/55) and mortality 0%. Delayed angiographic follow-up (48 aneurysms) at median 12 months postprocedure (range 3–36 months) demonstrated adequate occlusion of 83.4% of aneurysms. Conclusion The pCONUS2 and pCONUS2 HPC devices carry a high technical success rate, low complication and retreatment rate, and good rates of adequate occlusion. Larger prospective confirmatory studies are required.

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Complex Wide-necked and Lobulated Aneurysm of the Middle Cerebral Artery Bifurcation

Cited by 4 publications

References 24 publications

Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects

Endovascular treatment of middle cerebral artery aneurysms: current status and future prospects

Comaneci plus Balloon-assisted Embolization of Ruptured Wide-necked Cerebral Aneurysms

The pCONUS2 and pCONUS2 HPC Neck Bridging Devices

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