Artikel
Coiling of wide-necked intracranial aneurysms assisted by a temporary bridging device (Comaneci) – preliminary experience
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Veröffentlicht: | 8. Juni 2016 |
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Objective: Endovascular treatment of wide-necked aneurysms remains challenging without the use of adjunctive devices to preserve the parent artery. We present our initial experience with a temporary bridging device, the Comaneci (Rapid Medical, Israel). The compliant remodeling mesh protects the parent artery during coil occlusion without flow arrest in the distal vasculature. A permanent dual antiplatelet therapy is not required since the device is fully removed at the end of the procedure.
Method: All intracranial aneurysms treated by coil occlusion with the Comaneci device between 12/2014 and 11/2015 were included. Angiographic and clinical results were retrospectively analyzed including follow-up examinations. All aneurysms were unruptured.
Results: 15 aneurysms of the internal carotid artery were included. Successful coil occlusion assisted by the Comaneci device as intended was possible in 11 cases (73.0%). Insufficient coverage of the aneurysmal neck was observed in 4 cases (26%) with modification of the treatment concept to stent assisted coiling (n=1), remodeling technique (n=2) and sole coiling (n=1). One clinically relevant complication occurred (6.6%).
Conclusions: Our initial experience reveals that the Comaneci device is technically straightforward for the treatment of selected wide-necked aneurysms with a high likelihood of failure with conventional endovascular or microsurgical techniques. Further studies with long-term follow-up data are needed to identify the significance of the presented technique in the neurointerventional armamentarium.