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The pCONus Device in Treatment of Wide-necked Aneurysms

Technical and Midterm Clinical and Angiographic Results

Abstract

Purpose

A variety of devices for treatment of wide-necked bifurcation aneurysms are emerging. Here we report our results using the new pCONus device with special emphasis on the morphological and anatomical requirements for successful implantation.

Methods

In this study we treated 21 patients with 22 aneurysms by endovascular interventions. After providing informed consent, patients were included according to the following criteria: aneurysm dome to neck ratio <2 or neck diameter >4 mm. The primary end points for clinical safety were the absence of death, absence of major or minor stroke and absence of transient ischemic attack.

Results

A total of 22 aneurysms in 21 patients were treated with pCONus-assisted coiling. In 19 patients harboring 20 aneurysms the implantation of the device was successful and these aneurysms showed an adequate occlusion after 6 months in 95 %. The complication rate was low (5 %) with one case of minor neurological stroke. Analysis of the data showed that the difference in aneurysm angulation between successful (mean 45°) and failed implantations (mean 71.5°) was highly significant.

Conclusion

Use of the pCONus device and coiling in wide-necked bifurcation aneurysms is safe and provides good occlusion rates but might be limited by the angulation between the aneurysm and the parent vessel.

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Correspondence to M. Möhlenbruch.

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Conflict of Interests

C. Ulfert has received travel expenses from Bayer, Codman, Microvention and Stryker. J. Pfaff has received travel expenses from Siemens and Stryker. J. Bösel has received honoraria and travel expenses from Bard, Zoll, Seiratherm and Sedana Medical. M. Pham has received speaker fees and reimbursement of travel expenses from Penumbra, Covidien and Bayer. M. Bendszus has received fees and is consultant for Guerbet, Novartis, Codman and Roche. M. Möhlenbruch has received fees and is consultant for Acandis, Codman, Microvention, and Phenox and S. Schönenberger states that he has no conflict of interests.

Ethical standards

All investigations described in this manuscript were carried out in accordance with national law and the Helsinki Declaration of 1975 (in its current revised form). Ethics approval was obtained from the ethics committee of the University of Heidelberg. Informed consent was obtained from all patients included in the study or the legal representative.

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Ulfert, C., Pfaff, J., Schönenberger, S. et al. The pCONus Device in Treatment of Wide-necked Aneurysms. Clin Neuroradiol 28, 47–54 (2018). https://doi.org/10.1007/s00062-016-0542-z

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  • DOI: https://doi.org/10.1007/s00062-016-0542-z

Keywords

  • Aneurysm
  • Device
  • Coiling
  • Stent
  • Bifurcation