Department of Radiology and Neuroradiology, University Hospital Schleswig-Holstein, Campus Kiel, Christian-Albrechts University, Germany.
Institute of Neuroradiology, LMU-University Hospital, Ludwig-Maximilians-University, Munich, Germany.
Interv Neuroradiol. 2023 Feb;29(1):79-87. doi: 10.1177/15910199211069782. Epub 2022 Jan 11.
Wide-necked bifurcation aneurysms, partially thrombosed, and recurrences of large and giant aneurysms are challenging to treat. We report our preliminary experience with a Contour-assisted coiling technique and discuss the periprocedural safety, feasibility, and effectiveness of the approach.
We retrospectively reviewed consecutive patients who received endovascular treatment for intracranial aneurysms with an intra-aneurysmal flow disruptor (Contour) at two neurovascular centres between October 2018 and December 2020 and identified patients treated with a combination of Contour and platinum coils. Clinical and procedural data were recorded.
For this analysis, 8 patients (5 female) aged 60.1 ± 9.2 years on average were identified. Three of 8 aneurysms were associated with previous acute subarachnoid hemorrhage (SAH). The mean average dome height was 12.8 ± 7.6 mm, mean maximum dome width 10.3 ± 5.4 mm, and neck width 5.5 ± 2.5 mm. The mean dome-to-neck ratio was 1.9 ± 1.0. Immediate complete occlusion of the aneurysm was seen in 5 of 8 cases. In one SAH patient, a parent vessel was temporarily occluded but could be reopened rapidly. One device detached prematurely without any sequelae. No other procedural adverse events were recorded.
From this initial experience, Contour with adjunctive coiling is a safe and technically feasible method for endovascular treatment of large, wide-necked, partially thrombosed, recurrent, or ruptured bifurcation aneurysms. Further studies with larger numbers of patients and longer follow-up are needed to confirm our results.
宽颈分叉部动脉瘤、部分血栓形成以及大型和巨大型动脉瘤的复发是具有挑战性的治疗对象。我们报告使用 Contour 辅助弹簧圈技术的初步经验，并讨论该方法的围手术期安全性、可行性和有效性。
我们回顾性分析了 2018 年 10 月至 2020 年 12 月期间在两个神经血管中心接受颅内动脉瘤血管内治疗且使用了动脉瘤内血流阻断装置（Contour）的连续患者，并确定了使用 Contour 和铂金弹簧圈联合治疗的患者。记录临床和手术数据。
本分析共纳入 8 例患者（5 例女性），平均年龄为 60.1±9.2 岁。8 例动脉瘤中有 3 例与既往急性蛛网膜下腔出血（SAH）有关。平均瘤顶高度为 12.8±7.6 mm，最大瘤顶宽度为 10.3±5.4 mm，颈宽为 5.5±2.5 mm。瘤颈比的平均值为 1.9±1.0。8 例患者中有 5 例即刻完全闭塞动脉瘤。在 1 例 SAH 患者中，暂时闭塞了载瘤动脉，但可以迅速重新开放。1 个装置过早脱落，没有任何后遗症。未记录到其他手术不良事件。
从最初的经验来看，使用 Contour 辅助弹簧圈进行血管内治疗大型、宽颈、部分血栓形成、复发或破裂的分叉部动脉瘤是一种安全且技术可行的方法。需要进一步进行更大规模患者和更长随访时间的研究来证实我们的结果。
