Abstract
Background and purpose
Endovascular treatment of wide-neck bifurcation aneurysms has historically proved difficult with variable outcomes of efficacy and safety. We assessed the short- and long-term clinical and radiologic outcomes in the real-world use of Contour neurovascular system.
Materials and methods
This study was a retrospective analysis of unruptured intracranial aneurysms treated with the Contour. The primary radiologic outcomes were quantified on DSA, CTA, or MRA using the modified Raymond-Roy criteria. The outcomes were defined as complete occlusion (RROC 1) and adequate occlusion (RROC 1 and RROC 2) at 6 months and 2-years. The primary safety outcome was the rate of device-related adverse events. Secondary safety outcomes included time to discharge and change in the modified Rankin scale (mRS) score at 6-month follow-up.
Results
54 patients were treated with Contour from February 2017 to July 2022. 50 aneurysms underwent 6-month follow-up. 28 of 50 aneurysms treated (56%) remained completely occluded at 6-month follow-up (RROC 1), whilst 44 of 50 aneurysms treated (88%) were adequately occluded. 46 aneurysms underwent 2-year follow-up. 28 of 46 aneurysms treated (60.9%) remained completely occluded at 2-year follow-up (RROC 1), whilst 38 of 46 aneurysms (82.6%) were adequately occluded (RROC 1 and RROC2). Immediate postoperative complications occurred in 5 patients; only 1 patient (1.8%) had residual neurologic deficits at 6 months (mRS 1).
Conclusions
Management of wide-neck aneurysms remains difficult, with high rates of recurrence and complications. The use of the Contour demonstrated a promising and safe addition to the intravascular stock for the treatment of complex wide-neck aneurysms.
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