Ktayen Howra, Akhunbay-Fudge Christopher Yusuf, Tyagi Atul Kumar, Deniz Kenan, Patankar Tufail
From the Departments of Neurosurgery (H.K., C.Y.A.-F., A.K.T., K.D., Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
From the Departments of Neurosurgery (H.K., C.Y.A.-F., A.K.T., K.D., Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
AJNR Am J Neuroradiol. 2025 Jul 1;46(7):1387-1394. doi: 10.3174/ajnr.A8641.
The Contour neurovascular embolization device is a novel way to treat wide-neck bifurcation aneurysms (WNBA), which often pose considerable treatment challenges. In this study, we aim to evaluate the efficacy and safety profile of this device.
Prospective clinical and radiologic data were collected for all patients treated with the Contour device at our center, between January 2017 and December 2018. All patients were treated electively, and aneurysms were unruptured.
Fourteen patients were recruited, and the device was successfully deployed in 11 patients. All patients were women with a mean age of 65 years. Four basilar tip, 2 internal carotid, 3 middle cerebral, 1 anterior communicating, and 1 superior cerebellar artery aneurysms were treated. The mean aneurysmal size was 6 mm (width) × 7.6 mm (height), with 4.1 mm neck. Follow-up imaging included DSA, MRA, and CTA. For the 9 patients available at year 2 follow-up, 5 showed improved occlusion class over time with 8 of 9 having adequate occlusion defined by class 1 and 2 of the Raymond-Roy (R-R) classification system. Eight patients were available for 3-year follow-up: 7 patients had stable occlusion class including 3 patients with stable complete occlusion (R-R class 1). One patient had worsening of R-R occlusion class from 1 to 2 and subsequently presented with acute subarachnoid hemorrhage. Follow-up data 5 years after implantation were available for 8 patients (including the ruptured and re-treated patient): 7 patients had adequate occlusion (R-R class 1 and 2), however, 1 patient had worsened from R-R class 1 to R-R class 2. Four patients had complete occlusion.
Results demonstrate progressive occlusion of wide-neck aneurysms over the first 2 years, but we have also demonstrated worsening of R-R occlusion class in some aneurysms that were previously completely occluded. Our results suggest that the Contour device is a good option in WNBA, however, it appears that patients must be followed up for a minimum of 5 years.
轮廓神经血管栓塞装置是治疗宽颈分叉动脉瘤（WNBA）的一种新方法，这类动脉瘤的治疗往往面临巨大挑战。在本研究中，我们旨在评估该装置的有效性和安全性。
收集了2017年1月至2018年12月期间在我们中心接受轮廓装置治疗的所有患者的前瞻性临床和放射学数据。所有患者均为择期治疗，动脉瘤未破裂。
招募了14名患者，其中11名患者成功植入该装置。所有患者均为女性，平均年龄65岁。治疗了4例基底动脉尖、2例颈内动脉、3例大脑中动脉、1例前交通动脉和1例小脑上动脉动脉瘤。动脉瘤平均大小为6毫米（宽）×7.6毫米（高），颈宽4.1毫米。随访影像包括数字减影血管造影（DSA）、磁共振血管造影（MRA）和CT血管造影（CTA）。在2年随访时可获得9例患者的资料，其中5例随着时间推移闭塞等级有所改善，9例中有8例达到Raymond-Roy（R-R）分类系统1级和2级定义的充分闭塞。8例患者可进行3年随访：7例患者闭塞等级稳定，其中3例完全闭塞（R-R 1级）。1例患者R-R闭塞等级从1级恶化为2级，随后出现急性蛛网膜下腔出血。8例患者（包括破裂和再次治疗的患者）可获得植入后5年的随访数据：7例患者闭塞充分（R-R 1级和2级），然而，1例患者从R-R 1级恶化为R-R 2级。4例患者完全闭塞。
结果表明宽颈动脉瘤在最初2年内逐渐闭塞，但我们也发现一些先前完全闭塞的动脉瘤R-R闭塞等级恶化。我们的结果表明轮廓装置是治疗WNBA的一个不错选择，然而，似乎患者必须至少随访5年。
