Українська Інтервенційна Нейрорадіологія та Хірургія (Dec 2023)
Our experience with the using of pCONUS2 implant for endovascular occlusion of cerebral bifurcation aneurysms
Abstract
Objective ‒ to analyze the outcomes of endovascular treatment of aneurysms occluded by microcoils using pCONUS2 implants. Materials and methods. A retrospective analysis of treatment outcomes from January 2021 to March 2023 was conducted at the SO «Scientific-practical center of endovascular neuroradiology NAMS of Ukraine». Among 532 patients with cerebral aneurysms, 22 were treated with bifurcation implants pCONUS2 (Hydrophilic Polymer Coating (HPC)). The study group comprised 22 patients (11 females, 11 males, average age 53.01 years) with 26 aneurysms (3 patients had multiple aneurysms, one of which was excluded from use pCONUS2), including 9 (40.9 %) ruptured aneurysms. All of them were operated on during the acute period. Induction and controlled implantation of pCONUS2 were successfully performed in all patients. No technical problems have been registered that could make it difficult to navigate, start and detach the device. Results. Initial occlusion assessment using the modified Raymond-Roy classification (mRRC) showed total occlusion (mRRC 1) in 12 cases (54.5 %), near-complete occlusion (mRRC 2) in 6 cases (27.3 %), and residual filling (mRRC 3a and 3b) in 4 cases (18.2 %). Twenty-one patients were discharged or transferred for further treatment to the department of neurology with satisfactory treatment results (0–2 points on the modified Rankin Scale). One patient with a basilar artery aneurysm died from subarachnoid hemorrhage and severe vasospasm (6 points on the modified Rankin Scale). Angiographic follow-up was available for 9 patients, with stable occlusion in 7 cases and improvement from mRRC 3a to mRRC 1 in 2 cases. Conclusions. pCONUS bifurcation implants serve as an additional tool for treating wide-neck cerebral aneurysms, demonstrating high technical success rates and low complication and mortality rates.
