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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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A novel extra – intraaneurysmatic stent (pCONus) for the endovascular treatment of wide-neck bifurcation aneurysms

Meeting Abstract

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  • Marta Aguilar-Pérez - Klinikum Stuttgart, Klinik für Neuroradiologie, Stuttgart, Deutschland
  • Wiebke Kurre - Klinikum Stuttgart, Klinik für Neuroradiologie, Stuttgart, Deutschland
  • Sebastian Fischer - Klinikum Stuttgart, Klinik für Neuroradiologie, Stuttgart, Deutschland
  • Firas Thaher - Klinikum Stuttgart, Klinik für Neurochirurgie, Stuttgart, Deutschland
  • Hansjörg Bäzner - Klinikum Stuttgart, Klinik für Neurologie, Stuttgart, Deutschland
  • Hans Henkes - Klinikum Stuttgart, Klinik für Neuroradiologie, Stuttgart, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMI.05.06

doi: 10.3205/14dgnc303, urn:nbn:de:0183-14dgnc3037

Published: May 13, 2014

© 2014 Aguilar-Pérez et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: The endovascular treatment of intracranial aneurysms has limitations in wide neck bifurcation aneurysms. pCONus is a stent-like, self-expanding Nitinol implant with four distal loops and a nylon cross within the distal stent shaft. The shaft is deployed to the parent vessel, with the distal loops inside the aneurysm at the neck level. The four loops and the nylon cross create an artificial border between the aneurysm neck and the parent artery. pCONus retains detachable coils within the aneurysms and prevents coil prolapse into the parent vessel. The technique of pCONus assisted coil treatment and the related safety and efficacy margins will be presented.

Method: 28 patients and wide neck bifurcation aneurysms were enrolled. pCONus treatment was chosen if surgical difficulty was anticipated or the patients refused operative treatment. 14 aneurysms were unruptured and not treated previously, 5 were previously coiled, and 9 were treated in the acute phase after SAH. Aneurysm locations were as follows: 11 MCA, 8 AcomA/A2, 8 BA and 1 PCA. The fundus size varied from 4–22 mm.

Results: Insertion and deployment of pCONus allowed a complete (8) or subtotal (9) aneurysm occlusion in 17 aneurysms, with 11 partial aneurysm occlusions. No hemorrhagic complication was encounterd. Follow-up DSA was available in 22 aneurysms, with complete (13), subtotal (6) and partial (3) occlusion.

Conclusions: pCONus assisted coil occlusion is a viable option for the endovascular treatment of wide neck bifurcation aneurysms. Long-term follow-up data is still missing.