Department of Interventional Neuroradiology, 70496Erasme University Hospital, Belgium.
Department of Neurology, 70496Erasme University Hospital, Belgium.
Interv Neuroradiol. 2022 Aug;28(4):455-462. doi: 10.1177/15910199211040279. Epub 2021 Sep 13.
Wide-neck bifurcation aneurysms remain challenging for the neurointerventionist and/or neurosurgeon despite many recent advances. The pCONus (Phenox, Bochum, Germany) is an emerging device for endovascular neck protection, we report the first long-term results of this device.
We performed a retrospective analysis of all consecutive intracranial wide-neck bifurcation aneurysms treated with the pCONus. Patients' characteristics were reviewed, procedural complications, angiographic (Roy-Raymond scale) and clinical outcomes were documented.
Between January 2016 and September 2019, 43 patients (74% female, median age 56 [49-66] years) with 43 wide-neck bifurcation aneurysms (mean width of 6.8 ± 2.1 mm, dome/neck ratio of 1.3 ± 0.2 and neck of 5.2 ± 1.3 mm) were included. A procedural angiographic complication was reported in five patients (12%), no patient presented a post-operative neurological deficit or long-term complication, mortality rate was 0%. At last follow-up (median of 46.5 months [38.3-51.7]), an adequate occlusion (complete and neck remnant) was observed in 37/43 patients (86%) and an aneurysm remnant in 6/43 (14%). Four patients (9%) needed retreatment. No in-stent stenosis or branch occlusion was depicted.
pCONus device provides a safe and efficient alternative for endovascular wide-neck bifurcation aneurysms management, with long-term stability.
尽管神经介入和/或神经外科技术取得了许多进展，宽颈分叉部动脉瘤仍然是一个挑战。pCONus（德国 Phenox 公司）是一种新兴的血管内颈部保护装置，我们报告了该装置的首个长期结果。
我们对使用 pCONus 治疗的所有连续颅内宽颈分叉部动脉瘤患者进行了回顾性分析。回顾了患者的特征，记录了手术并发症、血管造影（Roy-Raymond 分级）和临床结果。
2016 年 1 月至 2019 年 9 月，共纳入 43 例（74%为女性，中位年龄 56 [49-66] 岁）的 43 个宽颈分叉部动脉瘤（平均颈宽 6.8±2.1mm，瘤颈比 1.3±0.2，颈宽 5.2±1.3mm）。5 例（12%）患者出现手术血管造影并发症，无患者出现术后神经功能缺损或长期并发症，死亡率为 0%。末次随访（中位数为 46.5 个月[38.3-51.7]），43 例患者中有 37 例（86%）达到了充分闭塞（完全闭塞和残余瘤颈），6 例（14%）有残余动脉瘤。4 例（9%）需要再次治疗。未发现支架内狭窄或分支闭塞。
pCONus 装置为宽颈分叉部动脉瘤的血管内治疗提供了一种安全有效的替代方法，具有长期稳定性。
