Endovascular treatment of wide-necked intracranial aneurysms using the novel Contour Neurovascular System: a single-center safety and feasibility study

Abstract

Background and purposeWide-necked bifurcation aneurysms pose a significant challenge to the treating clinician. The Contour Neurovascular System embolization device is a novel tool for the treatment of such intracranial aneurysms. We report on our experience with this device.MethodsProspective clinical and radiological data were collected for all patients treated with the Contour device at our center. All our patients were treated on an elective basis.ResultsWe have treated 11 patients successfully with the Contour device to date. All patients were women with a mean (SD) age of 65.0 (6.4) years. In total, four basilar tip, two internal carotid artery, three middle cerebral artery, one anterior communicating artery, and one superior cerebellar artery aneurysms were treated. At 1-year follow-up, complete occlusion (Raymond Class 1) was seen in 55.56% (5/9) of cases, with 44.44% (4/9) having small neck remnants (Raymond Class 2). One patient declined 1-year catheter angiography and another had no further follow-up due to an unrelated medical condition. For six patients, 2-year radiological follow-up is available and shows stability. At 6 weeks, nine of the 11 patients had a modifed Rankin Scale score of 0, with two patients scoring 1 for headaches. Two patients had thromboembolic events, but there were no complications leading to permanent neurological disability or death. We additionally had three patients where the Contour device was attempted but was unable to be successfully used.ConclusionInitial results are promising although larger case numbers and longer follow-up are necessary to draw further conclusions on the utility and risk profile of this new device.

The Woven EndoBridge for unruptured intracranial aneurysms: Results in 95 aneurysms from a single center

“…Lately new "neck-reconstructing" devices emerged and are available for the treatment of wide necked and bifurcation aneurysms (Contour, P-Conus, PulseRider, eCLIPse, Medina ea.). [39][40][41][42][43][44][45][46][47] These devices could be promising in those patients with a potential higher recurrence risk when using WEB treatment. However, the occlusion rate ranges from 50 to 83% depending on the device used.…”

EP10* Accuracy evaluation of derivo flow diverter deployed length predictions with presize neurovascular and comparison of device size selection between traditional planning and simulations

“…Metal artifacts are limiting MRI assessibility after implantation. 1 Aim The purpose of this in vitro study was to evaluate noninvasive imaging alternatives to DSA. Methods Three aneurysms of patients originally treated with CNS within a premarket study were 3D-printed.…”

“…They are neck bridging devices that prevent coil extrusion into the parent vessel. 1 It innovates on the previous generation by increasing the number of wire petals in the crown of the device from four to six, increasing stability of the implant, and shortening the length of the device shaft. Aims To summarise periprocedural outcomes, 6-month and 2year follow-up results following its introduction in a tertiary centre.…”

Nautilus-assisted coil embolization for a complex AcomA wide-necked aneurysm in the setting of acute subarachnoid hemorrhage

“…Numerous devices and sophisticated strategies have been developed to further increase the number of aneurysms amenable to endovascular treatment. [1][2][3][4] Despite the superfluity of available neurovascular armamentarium, wide-necked bifurcation aneurysms can still pose a significant technical challenge to the treating clinician. [5][6][7] Neck bridging is a conceptually new approach, which provides increased occlusion rates with lower recurrence and complications rates.…”