The ARTISSE intrasaccular device for intracranial aneurysm treatment: short-term, mid-term and long-term clinical and angiographic results

Piotin, Michel; Fahed, Robert; Redjem, Hocine; Smajda, Stanislas; Desilles, Jean‐Philippe; Escalard, Simon; Maïer, Benjamin; Hébert, Solène; Delvoye, François; Mazighi, Mikaël; Blanc, Raphaël

doi:10.1136/neurintsurg-2021-017806

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…The WEB clinical assessment of intrasaccular aneurysm therapy (WEBCAST), the French Observatory, WEBCAST 2, WEB-IT, ARTISSE ISD and the contour neurovascular system european pre-market unruptured aneurysm study. [35][36][37][38] Preliminary results demonstrated a high level of procedural safety and technical success.…”

Section: Discussionmentioning

confidence: 96%

Intrasaccular neck-bridging: A technical note on Nautilus-assisted coiling of wide-necked cerebral aneurysms. Feasibility study, immediate and early angiographic results

et al. 2022

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Purpose Various adjunctive devices have been reported to be helpful during the endovascular coiling of complex, wide-necked cerebral aneurysms. This study aimed to describe the utilization of a recently introduced intrasaccular neck-bridging implant specifically designed to facilitate coil embolization. Methods We retrospectively reviewed eight consecutive patients who underwent treatment for intracranial aneurysms with the Nautilus intrasaccular bridging system between February 2022 to May 2022. We evaluated the angiographic appearances of treated aneurysms at the end of the procedure and early follow-up, the clinical status and complications. Results Eight patients with eight cerebral aneurysms (3 men and 5 women, mean age 52.8 years (range 39–66) were analyzed. Five of the treated aneurysms were managed in an acute case scenario. There were no technical difficulties while executing the technique. No other procedural adverse events were documented. Immediate complete occlusion of the aneurysm was seen in 6 patients, neck remnant in 1 and stable aneurysm reperfusion in one case. Early radiological follow-up was available in five patients, and the observed occlusion rates were – RR class I in all radiologically screened aneurysms. Conclusion Nautilus-assisted coil embolization represents a rapid and safe solution for complex cerebral aneurysms. In our opinion this device symbolizes a significant step forward in treating intracranial aneurysms. We believe that the technique's actual value consists of the fact that the device is fully compatible with the modern low-profile microcatheter technology and does not involve the need for antiplatelet medications.

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Section: Discussionmentioning

confidence: 96%

Intrasaccular neck-bridging: A technical note on Nautilus-assisted coiling of wide-necked cerebral aneurysms. Feasibility study, immediate and early angiographic results

et al. 2022

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“…The Nautilus Intrasaccular System (EndoStream Medical, Or Akiva, Israel) is a novel intrasaccular device unavailable in the USA that has demonstrated low complication rates without the need for antiplatelet therapy in ruptured aneurysms [ 76 ]. The novel ARTISSE (Medtronic, Irvine, CA, USA) intrasaccular device, which is also not available in the USA, demonstrated thromboembolic complications in two out of the nine unruptured cases performed [ 77 ]. These patients were placed on antiplatelet therapy to prevent further strokes.…”

Section: Discussionmentioning

confidence: 99%

Trends in Dual Antiplatelet Therapy Use for Neurointerventional Procedures for the Management of Intracranial Aneurysms

et al. 2023

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The use of periprocedural dual antiplatelet therapy (DAPT) has significantly evolved along with innovations in the endovascular management of intracranial aneurysms. Historically, aspirin and clopidogrel have been the most commonly employed regimen due to its safety and efficacy. However, recent studies highlight the importance of tailoring DAPT regimens to individual patient characteristics which may affect clopidogrel metabolism, such as genetic polymorphisms. In the present report, a systematic review of the literature was performed to determine optimal antiplatelet use with flow diverting stents, intracranial stents, intrasaccular devices, and stent-assisted coiling. Studies were analyzed for the number of aneurysms treated, DAPT regimen, and any thromboembolic complications. Based on inclusion criteria, 368 studies were selected, which revealed the increasing popularity of alternative DAPT regimens with the aforementioned devices. Thromboembolic or hemorrhagic complications associated with antiplatelet medications were similar across all medications. DAPT with ticagrelor, tirofiban, or prasugrel are effective and safe alternatives to clopidogrel and do not require enzymatic activation. Further clinical trials are needed to evaluate different antiplatelet regimens with various devices to establish highest-level evidence-based guidelines and recommendations.

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“…Luna named Artisse in the newest version (5,62). Previous studies showed that the Luna/Artisse embolization system was safe and effective (86,87). However, further study with a large sample is needed.…”

Section: Luna/artisse Embolization Systemmentioning

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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The ARTISSE intrasaccular device for intracranial aneurysm treatment: short-term, mid-term and long-term clinical and angiographic results

Cited by 8 publications

References 15 publications

Intrasaccular neck-bridging: A technical note on Nautilus-assisted coiling of wide-necked cerebral aneurysms. Feasibility study, immediate and early angiographic results

Intrasaccular neck-bridging: A technical note on Nautilus-assisted coiling of wide-necked cerebral aneurysms. Feasibility study, immediate and early angiographic results

Trends in Dual Antiplatelet Therapy Use for Neurointerventional Procedures for the Management of Intracranial Aneurysms

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

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