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66th Annual Meeting of the German Society of Neurosurgery (DGNC)
Friendship Meeting with the Italian Society of Neurosurgery (SINch)

German Society of Neurosurgery (DGNC)

7 - 10 June 2015, Karlsruhe

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Single center experience in the endovascular treatment of wide-necked intracranial aneurysms with a bridging extra- and intraaneurysmal implant (pCONus)

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  • Sebastian Fischer - Institut für diagnostische Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum
  • Annika Kowoll - Institut für diagnostische Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum
  • Alexej Titschert - Institut für diagnostische Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum
  • Anushe Weber - Institut für diagnostische Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum
  • Werner Weber - Institut für diagnostische Radiologie, Neuroradiologie und Nuklearmedizin, Universitätsklinikum Knappschaftskrankenhaus Bochum

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMO.09.05

doi: 10.3205/15dgnc042, urn:nbn:de:0183-15dgnc0423

Published: June 2, 2015

© 2015 Fischer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: To retrospectively evaluate the safety and efficacy in the endovascular treatment of wide-necked intracranial aneurysms assisted by a novel intra- and extraaneurysmatic stent-like implant (pCONus)

Method: Initial and follow-up angiographic and clinical results of 21 patients with 21 intracranial unruptured (n=16) and ruptured (n=5) wide-necked intracranial aneurysms treated by reconstruction of the aneurysmal orifice using the pCONus implant followed by coil occlusion of the fundus between february 2013 and october 2014.

Results: Successful intra-extraaneurysmal deployment of the pCONus with coil occlusion of the aneurysm was achieved in all but one case. Procedure related clinically relevant complications were observed in one case.

Initial complete occlusion (100%) with proper reconstruction of the aneurysmal neck was achieved in 8 cases, a small neck remnant (90-99%) remained in 12 aneurysms. Follow-up angiographies after 3 months were carried out in 11 patients and revealed a complete occlusion (100%) in 5 and a small unchanged remnant (90-99%) in 6 cases. Intimal hyperplasia in the stented segment of the parent artery or a device migration was not observed to date.

Conclusions: The pCONus device offers a promising endovascular treatment option for complex wide necked intracranial bifurcation aneurysms. Acute or delayed dislocations of coils into the parent artery are successfully avoided.