Use of the pCONus as an adjunct to coil embolization of acutely ruptured aneurysms

Pérez, Marta Aguilar; Bhogal, Pervinder; Moreno, Rosa Martínez; Wendl, Christina; Bäzner, Hansjörg; Ganslandt, Oliver; Henkes, Hans

doi:10.1136/neurintsurg-2016-012508

Cited by 40 publications

(17 citation statements)

References 21 publications

(15 reference statements)

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“…Immediate angiogram results showed complete occlusion in one patient and 5 small aneurysm and neck remnants. In line with other studies, the overall performance of the device has so far produced satisfactory clinical results [23][24][25][26][27]. There were no significant clinical complications associated with the use of the device and all patients were discharged with no permanent neurological deficits.…”

Section: Discussionsupporting

confidence: 63%

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Endovascular Treatment with the pCONus Device: Initial Experience in a Single UK Centre

Saeed¹

2017

AVS

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Section: Discussionsupporting

confidence: 63%

“…There are several studies that have assessed the effectiveness of the pCONus device in unruptured aneurysms but only one currently published study on its use in ruptured aneurysms [23][24][25][26]. Aguilar-Perez et al, 2016, has shown encouraging results in 21 patients with ruptured aneurysms that were treated with the pCONus device [23].…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment with the pCONus Device: Initial Experience in a Single UK Centre

Saeed¹

2017

AVS

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“…Perioperative morbidity and mortality rates were low (7% and 0%, respectively). So far, only one series has focused on the use of the pCONUS exclusively in acutely ruptured aneurysms 19. In that series of 21 patients, intraoperative complications without permanent morbidity were seen in two patients (one thromboembolic and one hemorrhagic).…”

Section: Discussionmentioning

confidence: 99%

Use of the pCONus HPC as an adjunct to coil occlusion of acutely ruptured aneurysms: early clinical experience using single antiplatelet therapy

Aguilar-Pérez

AlMatter

Hellstern

et al. 2020

J NeuroIntervent Surg

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BackgroundCoil occlusion has become the standard treatment for many ruptured aneurysms. However, specific aneurysm structures pose technical difficulties and may require the use of adjunctive neck-bridging devices, which necessitate the use of dual antiplatelet therapy. The hydrophilic polymer coating (pHPC, phenox) is a surface modification that inhibits platelet adhesion.ObjectiveTo present initial experience with the pCONUS HPC device as an adjunct to coil embolization for ruptured aneurysms using single antiplatelet therapy (SAPT).MethodsAll patients who were treated with the pCONUS HPC for ruptured aneurysms using SAPT were retrospectively identified. The occurrence of thromboembolic and hemorrhagic complications was recorded together with the angiographic and clinical follow-up details.ResultsFifteen patients were identified (nine female) with a median age of 54 years (range 27–81). Six aneurysms were located at the anterior communicating artery, five at the middle cerebral artery bifurcation, two at the basilar artery bifurcation, one at the posterior communicating artery, and one involving the intradural internal carotid artery. Ten patients (66.6%) achieved modified Raymond–Roy classification I or II at post-treatment angiography, with 45.5% of patients having adequate occlusion (defined as complete occlusion or neck remnant) at follow-up. All patients received acetylsalicylic acid (ASA) as SAPT before and after the procedure. Intraprocedural thrombus formation was seen in three patients (20%), resolving in two patients after a bolus dose of eptifibatide, and one treated with mechanical aspiration. No clinical or radiological consequences were seen. There were no recurrent aneurysm ruptures. One patient died owing to cerebral vasospasm.ConclusionThis initial clinical experience highlights the possibility and limitations of using the pCONUS HPC device in the treatment of complex ruptured aneurysm with ASA as SAPT. Randomized trials with longer follow-up in larger cohorts are underway.

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“…There are several existing neck bridging devices, including the pCONus1, PulseRider ® , and the eCLIPs™. Numerous case series have been published detailing the use of the pCONus1 in both ruptured and unruptured aneurysms as well as in conjunction with other devices [12][13][14][15][16]. Gory et al [17] recently published their 1-year results on the use of the pCONus1 in wide-necked middle cerebral artery aneurysms.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Wide-Necked Bifurcation Aneurysms

et al. 2018

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Background Recently, numerous devices dedicated to the treatment of wide-necked aneurysms have become available. We present our initial experience with the pCANvas device and present the technical success rate, clinical outcome and immediate angiographic occlusion rates. Objective We sought to determine the efficacy of flow with the pCANvas for the treatment of unruptured intracranial aneurysms. Methods We performed a retrospective review of our prospectively collected data to identify patients treated with the pCANvas device between February 2015 and February 2017. The patient demographics, aneurysm characteristics, immediate and delayed clinical and radiographic follow-up data were recorded. Results We identified 17 patients (13 female) treated only with the pCANvas device. The average age of the patients was 60.5 ± 13.3 years (range 25-75 years). The average dome width was 7.6 ± 3.2 mm (range 3-15.8 mm), dome height 7.1 ± 3.2 mm (range 3-12.9 mm) and neck width 5.4 ± 3.2 (range 3-16.3 mm). The average aspect ratio was 1.5 ± 0.8 (range 0.6-3.7). At the end of the procedure 15 aneurysms continued complete filling of the aneurysm (Raymond Roy Classification[RRC] 3) with 2 aneurysms showing only filling of the neck of the aneurysm (RRC 2). Early follow-up angiography was available for 16 patients and at this stage 11 aneurysms showed persistent and complete filling of the aneurysm (RRC 3), 5 aneurysms showed complete occlusion of the aneurysm (RRC 1) and 7 aneurysms underwent repeat treatment with coiling. Conclusion The early results on the use of the pCANvas are promising; however, longer term follow-up and larger studies are required.

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Use of the pCONus as an adjunct to coil embolization of acutely ruptured aneurysms

Cited by 40 publications

References 21 publications

Endovascular Treatment with the pCONus Device: Initial Experience in a Single UK Centre

Endovascular Treatment with the pCONus Device: Initial Experience in a Single UK Centre

Use of the pCONus HPC as an adjunct to coil occlusion of acutely ruptured aneurysms: early clinical experience using single antiplatelet therapy

Treatment of Wide-Necked Bifurcation Aneurysms

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