Wodarg Fritz, Neves Fernando Bueno, Gärtner Friederike, Larsen Naomi, Peters Sönke, Hensler Johannes, Klintz Tristan, Mahnke Justus, Ahmeti Hajrullah, Doukas Alexander, Jansen Olav, Mostafa Karim
From the Department of Radiology and Neuroradiology (F.W., F.B.N., F.G., N.L., S.P., J.H., T.K., J.M., O.J., K.M.), University Hospital Schleswig Holstein, Campus Kiel, Kiel, Germany.
Department of Neurosurgery (H.A., A.D.), University hospital Schleswig Holstein, Campus Kiel, Kiel, Germany.
AJNR Am J Neuroradiol. 2025 Apr 2;46(4):698-705. doi: 10.3174/ajnr.A8606.
Aneurysmal disease of the intracranial vasculature poses a relevant threat, warranting effective interventions. Minimally invasive interventional techniques for aneurysm treatment have evolved to the application of flow-diversion stents and devices. This study focuses on the Contour Neurovascular System (CNS), aiming to add knowledge regarding its mid- to long-term outcomes in treating wide-necked intracranial aneurysms.
Conducted in accordance with STROBE guidelines, this study retrospectively evaluated all patients with intracranial aneurysms treated with CNS embolization. Demographic and interventional data were collected retrospectively, including aneurysm characteristics, procedural details, and angiographic follow-up evaluations up to 24 months after CNS implantation.
A total of 106 patients with 109 aneurysms were included in this study, whereby 72 patients were treated for an incidental aneurysm, while 34 patients presented with subarachnoid hemorrhage. Implantation was successful in 95.5% of patients. Occlusion rates were as follows: 6 months (69/106, 65.1%): Raymond-Roy-Scale (RRS) 1 44/69 (63.4%), RRS 2 16/69 (23.1%), RRS 3a 4/69 (5.8%), RRS 3b 5/69 (7.2%); 12 months (44/106, 41.5%): RRS 1 24/44 (55.5%), RRS 2 12/44 (27.3%), RRS 3a 4/44 (9.0%), RRS 3b 4/44 (9.0%); 24 months (30/106, 28.3%): RRS 1 21/30 (70.0%), RRS 2 8/30 (26.7%), RRS 3b 1/30 (3.3%). Periprocedural complications: Overall 8/106 (7.5%); elective cases 4/72 (5.5%); aneurysm rupture 4/34 (11.7%). Adjunctive devices were used in 13/106 cases (12.2%).
The present work reports the long-term angiographic and clinical follow-up results of a single-center cohort of 106 patients with intracranial aneurysms treated with the CNS. The CNS demonstrated a high rate of successful implantation and promising mid- and long-term stability, with a low reintervention rate beyond 24 months in patients exhibiting early occlusion at 6 months. While acknowledging the limitations, these findings contribute valuable information about the safety and efficacy of the CNS, and warrant continued exploration in larger, prospective studies to validate its role in aneurysm treatment.
颅内血管的动脉瘤性疾病构成了重大威胁，需要有效的干预措施。用于动脉瘤治疗的微创介入技术已发展到应用血流导向支架和装置。本研究聚焦于轮廓神经血管系统（CNS），旨在增加关于其治疗宽颈颅内动脉瘤的中长期结果的知识。
本研究按照STROBE指南进行，回顾性评估了所有接受CNS栓塞治疗的颅内动脉瘤患者。回顾性收集了人口统计学和介入数据，包括动脉瘤特征、手术细节以及CNS植入后长达24个月的血管造影随访评估。
本研究共纳入106例患者的109个动脉瘤，其中72例患者治疗的是偶然发现的动脉瘤，34例患者出现蛛网膜下腔出血。95.5%的患者植入成功。闭塞率如下：6个月（69/106，65.1%）：雷蒙德-罗伊分级（RRS）1级44/69（63.4%），RRS 2级16/69（23.1%），RRS 3a级4/69（5.8%），RRS 3b级5/69（7.2%）；12个月（44/106，41.5%）：RRS 1级24/44（55.5%），RRS 2级12/44（27.3%），RRS 3a级4/44（9.0%），RRS 3b级4/44（9.0%）；24个月（30/106，28.3%）：RRS 1级21/30（70.0%），RRS 2级8/30（26.7%），RRS 3b级1/30（3.3%）。围手术期并发症：总体8/106（7.5%）；择期病例4/72（5.5%）；动脉瘤破裂4/34（11.7%）。13/106例（12.2%）使用了辅助装置。
本研究报告了106例接受CNS治疗的颅内动脉瘤单中心队列的长期血管造影和临床随访结果。CNS显示出高植入成功率和良好的中长期稳定性，6个月时早期闭塞的患者在24个月后再干预率较低。尽管认识到局限性，但这些发现为CNS的安全性和有效性提供了有价值的信息，并且有必要在更大规模的前瞻性研究中继续探索以验证其在动脉瘤治疗中的作用。
