Mostafa Karim, Bueno Neves Fernando, Gärtner Friederike, Peters Sönke, Hensler Johannes, Larsen Naomi, Klintz Tristan, Mahnke Justus, Flüh Charlotte, Jansen Olav, Wodarg Fritz
Department of Radiology and Neuroradiology, University Hospital Schleswig Holstein, Kiel, Germany.
Department of Neurosurgery, University Hospital Schleswig Holstein, Kiel, Germany.
Interv Neuroradiol. 2023 Dec 10:15910199231219018. doi: 10.1177/15910199231219018.
Treatment of basilar apex aneurysms will remain challenging regarding the nobility of the parent vessel and their often wide-necked configuration. With endovascular techniques being the treatment approach of choice, novel intrasaccular flow-disruption devices constitute an endovascular embolization option. In this research, we report our experiences in embolizing basilar tip aneurysms with the novel Contour device.
Retrospective analysis of eight patients after Contour implantation into a basilar apex aneurysm. Periprocedural data on intervention times, radiation dose, procedural success and complications were gathered. All patients received follow-up digital subtraction angiography after six months. Further follow-up examination results were analysed given their availability.
Contour implantation was successful in all patients. The mean device instrumentation time was 18.8 ± 7.7 min with a mean full intervention time of 100 ± 65.8 min. The mean full procedure radiation dose was 1917 (421-5107) cGy/cm. After six months, six aneurysms were occluded (Raymond Roy Scale (RRS) 1/2), one showed perfusion inside the device (RRS 3a) and one patient had undergone reintervention due to progression. The aneurysm with constant perfusion at six months was seen to be occluded after 24 months.
Contour device implantation is a promising feasible alternative endovascular method for embolization of intracranial aneurysms located in the basilar tip with short intervention times and low radiation dosages. Short- and medium-term follow-ups show promising results concerning aneurysm occlusion and reinterventions, however further research is needed to show long-term stability.
鉴于基底动脉尖动脉瘤供血血管的特殊性及其通常的宽颈结构，其治疗仍具有挑战性。随着血管内技术成为首选治疗方法，新型瘤内血流阻断装置构成了一种血管内栓塞选择。在本研究中，我们报告了使用新型Contour装置栓塞基底动脉尖动脉瘤的经验。
对8例将Contour装置植入基底动脉尖动脉瘤的患者进行回顾性分析。收集了关于干预时间、辐射剂量、手术成功率和并发症的围手术期数据。所有患者在6个月后接受了随访数字减影血管造影。根据可获得的进一步随访检查结果进行分析。
所有患者Contour装置植入均成功。平均装置置入时间为18.8±7.7分钟，平均全干预时间为100±65.8分钟。平均全手术辐射剂量为1917（421 - 5107）cGy/cm。6个月后，6个动脉瘤闭塞（Raymond Roy分级（RRS）1/2级），1个在装置内有血流灌注（RRS 3a级），1例患者因病情进展接受了再次干预。6个月时持续有血流灌注的动脉瘤在24个月后被闭塞。
Contour装置植入是一种有前景的可行的血管内替代方法，用于栓塞位于基底动脉尖的颅内动脉瘤，具有干预时间短和辐射剂量低的特点。短期和中期随访显示在动脉瘤闭塞和再次干预方面有良好结果，然而需要进一步研究以显示长期稳定性。
