Safety and efficacy of the Derivo Embolization Device for the treatment of unruptured intracranial aneurysms: a multicentric study

Kraus, Bastian; Goertz, Lukas; Turowski, Bernd; Borggrefe, Jan; Schlamann, Marc; Dorn, Franziska; Kabbasch, Christoph

doi:10.1136/neurintsurg-2018-013963

Cited by 37 publications

(31 citation statements)

References 23 publications

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“…Improvements in the device are more likely in terms of safety compared with this series. Similar rates have also been recently reported in two small multi-centre series with 42 unruptured and 11 ruptured aneurysms treated with DED (7,12). Our results further confirmed the safety and efficacy of DED in a real-world setting and in a large series of patients.…”

Section: Resultssupporting

confidence: 89%

The experience of derivoŽ embolisation device in intracranial aneurysms

Dağlıoğlu¹,

Akmangit²,

Açık³

et al. 2019

Turkish Neurosurgery

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AIM:To investigate the safety and efficacy of Derivo ® embolisation device (DED), a new-generation flow diverter designed to treat cerebrovascular aneurysms, and its long-term clinical outcomes. MATERIAL and METHODS:In total, 146 patients with 182 aneurysms were treated with DED. The mean age of the participants was 51.5 years; among them, 46 (31.5%) presented with acute subarachnoid haemorrhage. The mean aneurysm size was 8.3 mm, and 12 aneurysms were involved the vertebrobasilar system. Ophthalmic aneurysms account for most internal carotid artery (ICA) aneurysms. RESULTS:The Glasgow Coma Scale (GCS) score of 12 patients was <15. DED was associated with a mortality rate of 2.7% and permanent morbidity rate of 3.4%, and a complete aneurysm occlusion rate was achieved in 78.7% of cases after 7.02 months. CONCLUSION:The DED device is a new-generation flow diverter with excellent opening behaviour and navigational benefits. Our results indicated a safe aneurysm occlusion with optimum morbidity and mortality values despite the fact that almost one-third of the patients presented with subarachnoid haemorrhage.

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Section: Resultssupporting

confidence: 89%

The experience of derivoŽ embolisation device in intracranial aneurysms

Dağlıoğlu¹,

Akmangit²,

Açık³

et al. 2019

Turkish Neurosurgery

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“…Among intracranial stents and flow diverters, several in vivo and ex vivo studies have already suggested that miniaturization of the stent design and the delivery system may reduce the thrombogenicity of the device. [25][26][27][28] Hence, miniaturization of the WEB system might also contribute to reduced thrombogenicity of the system. Moreover, we observed that the WEB 17 showed a reduced tendency to protrude into the parent vessel, though we did not quantify this aspect.…”

Section: Discussionmentioning

confidence: 99%

Low-Profile Intra-Aneurysmal Flow Disruptor WEB 17 versus WEB Predecessor Systems for Treatment of Small Intracranial Aneurysms: Comparative Analysis of Procedural Safety and Feasibility

Goertz

Liebig²,

Siebert

et al. 2019

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: The Woven EndoBridge 17 has recently been introduced to the market for facilitated endovascular treatment of small bifurcation aneurysms (7 mm) with low-profile microcatheters. We compared the Woven EndoBridge 17 with its predecessor versions in terms of procedural safety and feasibility. MATERIALS AND METHODS: This was a multicenter review of aneurysms ranging from 3 to 7 mm treated with the Woven EndoBridge between 2011 and 2019. Aneurysm characteristics, procedural parameters, and complications were retrospectively compared between treatment with the Woven EndoBridge 17 and a control group that was treated with its predecessor versions, using inverse probability of treatment weighting. RESULTS: Thirty-eight aneurysms treated with a Woven EndoBridge 17 (mean size, 4.9 6 1.5 mm) and 70 treated with a predecessor version of the Woven EndoBridge 17 (mean size, 5.6 6 1.4 mm) were included. The predecessor version of the Woven EndoBridge 17 had a higher failure rate (10.3%) than the Woven EndoBridge 17 (0%, P = .05). Additional stent placement was performed more often with the predecessor version of the Woven EndoBridge 17 (10.0%) than with the Woven EndoBridge 17 (2.6%, adjusted P = .005). The predecessor version of the Woven EndoBridge 17 was associated with a higher thromboembolic event rate (14.3%) than the Woven EndoBridge 17 (5.3%, adjusted P = .002). Neurologic complications (Woven EndoBridge 17: 2.6%; predecessor version of the Woven EndoBridge 17: 2.9%, adjusted P = 1.0) and immediate complete aneurysm occlusion rates (Woven EndoBridge 17: 57.9%; predecessor version of the Woven EndoBridge 17: 54.3%, adjusted P = .21) did not differ significantly between groups. CONCLUSIONS: In the current study, the Woven EndoBridge 17 was associated with a potentially lower thromboembolic event rate than the predecessor version of the Woven EndoBridge 17, without compromising the immediate aneurysm occlusion rate. Long-term clinical and angiographic outcome analysis will be necessary to draw a definite conclusion. ABBREVIATIONS: AcomA ¼ anterior communicating artery; IPTW ¼ inverse probability of treatment weighting; pWEB ¼ predecessor version of the Woven EndoBridge 17; SL ¼ Single-Layer; WEB ¼ Woven EndoBridge

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“…The need for antiplatelet therapy and risk of rebleeding due to delayed aneurysm occlusion are potential drawbacks to flow diversion that must be considered in the treatment of ruptured aneurysms, especially in the case of highly vulnerable RBAs and RDAs. The Derivo Embolization Device (Derivo) is a novel flow diverter stent that has demonstrated high procedural safety and sufficient occlusion rates in the treatment of UIAs (5). In this case series, we report our single-center experience in treating acutely RDAs and RBAs with the Derivo to evaluate safety, effectiveness, and short-term follow-up.…”

Section: Introductionmentioning

confidence: 99%

Single-center experience with the new generation Derivo Embolization Device in ruptured dissecting and blister aneurysms

2019

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Background Treatment of ruptured dissecting and blister aneurysms is technically challenging with potentially high morbidity and mortality. The Derivo Embolisation Device (Derivo) is a flow diverter stent designed for the treatment of intracranial aneurysms. Purpose To assess the safety and feasibility of the Derivo in the treatment of ruptured dissecting and blister aneurysms. Material and Methods We retrospectively analyzed all patients with ruptured dissecting and blister aneurysms treated with the Derivo between February 2016 and July 2018. Procedural details, complications, morbidity within 30 days, and angiographic aneurysm occlusion rates, initially and after six months, were assessed. Results In 10 patients 11 ruptured dissecting and blister aneurysms were treated with 12 Derivos as monotherapy. No aneurysm rebleeding was observed at follow-up. One treatment-related complication occurred including a coil perforation of an additionally treated aneurysm. One patient died due to brain edema. Initial digital subtraction angiography revealed complete (O’Kelly–Marotta [OKM] classification D) and favorable (OKM D+C) occlusion rate in three aneurysms. Six-month follow-up for digital subtraction angiography and clinical evaluation was available in 6/9 patients with complete (OKM D) occlusion in all aneurysms (6/6). Favorable (modified Rankin Scale [mRS] ≤ 2) and moderate (mRS 3) clinical outcome after a mean follow-up of 10 months was observed in six and two patients, respectively. Conclusion Endovascular treatment with the Derivo in ruptured dissecting and blister aneurysms revealed a sufficient initial division of aneurysms from the circulation without rebleeding. The Derivo is associated with high procedural and clinical short-term safety.

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Safety and efficacy of the Derivo Embolization Device for the treatment of unruptured intracranial aneurysms: a multicentric study

Abstract: Endovascular treatment of UIAs with the DED is associated with high procedural safety and adequate occlusion rates. Examinations at 1- and 2-year follow-up will provide data on the long-term safety and angiographic outcomes of this device.

Cited by 37 publications

References 23 publications

The experience of derivoŽ embolisation device in intracranial aneurysms

The experience of derivoŽ embolisation device in intracranial aneurysms

Low-Profile Intra-Aneurysmal Flow Disruptor WEB 17 versus WEB Predecessor Systems for Treatment of Small Intracranial Aneurysms: Comparative Analysis of Procedural Safety and Feasibility

Single-center experience with the new generation Derivo Embolization Device in ruptured dissecting and blister aneurysms

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