ECLIPs bifurcation remodeling system for treatment of wide neck bifurcation aneurysms with extremely low dome-to-neck and aspect ratios: A multicenter experience

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

  • Joost De Vries, Radboud University Nijmegen
  • ,
  • Hieronymus D. Boogaarts, Radboud University Nijmegen
  • ,
  • Leif Sørensen
  • Markus Holtmannspoetter, Københavns Universitet
  • ,
  • Goetz Benndorf, Københavns Universitet, Baylor College of Medicine
  • ,
  • Bernd Turowski, Heinrich Heine University Düsseldorf
  • ,
  • Georg Bohner, Charité-Universitätsmedizin Berlin
  • ,
  • Shahram Derakhshani, Queen's University Hospital
  • ,
  • Chema Navasa, University of Zaragoza
  • ,
  • Wim H. Van Zwam, Maastricht University
  • ,
  • Michael Söderman, Karolinska Institutet
  • ,
  • Riitta Rautio, University of Turku
  • ,
  • Christian Mathys, University of Oldenburg
  • ,
  • Howard Riina, New York University
  • ,
  • Thomas R. Marotta, University of Toronto

Background Wide necked bifurcation aneurysms (WNBA) are among the most difficult aneurysms to treat. Very low dome-to-neck (DTN) and aspect ratios provide an even greater challenge in the management of WNBAs. We present the safety and efficacy profile for endovascular clip system (eCLIPs) device in the treatment of this subset of WNBAs with very unfavorable morphologies. Methods In our case series, 24 patients treated at 12 international centers were taken from a larger prospective voluntary post-marketing registry of 65 patients treated with the eCLIPs device and coiling. Those who had WNBAs at either the carotid or basilar terminus with a DTN ratio <1.6 and aspect ratio <1.2 were included. Radiologic and clinical outcomes were assessed immediately after the procedure and at the latest follow-up. Results The eCLIPs device was successfully deployed in 23 cases (96%). One patient (4.2%) died due to guidewire perforation distal to the implant site. No other complications were documented. After a mean follow-up of 15.8 months (range 3-40 months), good radiologic outcomes (modified Raymond-Roy classification (MRRC) scores of 1 or 2) were documented in 20 of 21 patients (95%) with follow-up data. The lone patient with an MRRC score of 3 showed coiled compaction after incomplete neck coverage with the device. Conclusion Our series of patients with aneurysms having adverse DTN and aspect ratios demonstrated that the eCLIPs device has a safety and efficacy profile comparable with currently available devices in the treatment of WNBAs.

OriginalsprogEngelsk
TidsskriftJournal of NeuroInterventional Surgery
Vol/bind13
Nummer5
Sider (fra-til)438-442
Antal sider5
ISSN1759-8478
DOI
StatusUdgivet - 1 maj 2021

Bibliografisk note

Publisher Copyright:
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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