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The Barrel Vascular Reconstruction Device

A Retrospective, Observational Multicentric Study

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Abstract

Background and Purpose

The Barrel device is an electrolytically detachable laser cut, closed-cell microstent that is used for neck reconstruction in wide-necked bifurcation and branching aneurysms to support coiling. The key feature is a barrel section that herniates over the aneurysmal ostium. The objective was to evaluate the safety, feasibility and the immediate and mid-term occlusion results of this new device.

Material and Methods

The databases of two tertiary care centers were screened for all Barrel-based stent-assisted intracranial coil embolization of wide-necked aneurysms between June 2015 and September 2016. Case files and imaging data were retrospectively analyzed for angiographic and clinical outcome parameters, including immediate and mid-term modified Raymond-Roy aneurysm occlusion classification (RROC) rates and procedural complications.

Results

A total of 21 patients comprising 21 intracranial aneurysms (20 unruptured, 1 ruptured) were treated with the Barrel device and additional coiling of the aneurysm sac. All aneurysms were wide-necked, saccular bifurcation aneurysms defined by a dome/neck ratio ≤2. Immediate complete occlusion (RROC1) was observed in 19/21 (90%). An intra-interventional in-stent thrombus formation in two cases (10%) was medically resolved without neurological sequelae. A single case of symptomatic in-stent stenosis (5%) was cleared by balloon angioplasty. Follow-up (FU) was available in 20/21 cases (95%) after a median of 282 days (range: 17–591 days). At follow-up 19/20 aneurysms (95%) were completely occluded (RROC1).

Conclusion

The Barrel device showed a satisfactory safety profile and a promising rate of immediate and mid-term complete aneurysm occlusion for stent-assisted coil embolization of wide-necked intracranial bifurcation aneurysms, warranting further investigation of the device.

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Data sharing statement: All data will be made available on request in an anonymized manner.

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Authors and Affiliations

  1. Department of Radiology and Neuroradiology, University Hospital of Cologne, Kerpener Straße 62, 50924, Cologne, Germany

    C. Kabbasch, A. Mpotsaris & V. Maus

  2. Department of Neuroradiology, University Hospital of Aachen, 52074, Aachen, Germany

    A. Mpotsaris

  3. Department of Radiology and Neuroradiology, Klinikum Vest – Knappschaftskrankenhaus Recklinghausen, 45657, Recklinghausen, Germany

    J. C. Altenbernd & C. Loehr

Authors
  1. C. Kabbasch
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  2. A. Mpotsaris
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  5. C. Loehr
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Correspondence to C. Kabbasch.

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Conflict of interest

C. Kabbasch, A. Mpotsaris, V. Maus, J.C. Altenbernd and C. Loehr declare that they have no competing interests.

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This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Kabbasch, C., Mpotsaris, A., Maus, V. et al. The Barrel Vascular Reconstruction Device. Clin Neuroradiol 29, 295–301 (2019). https://doi.org/10.1007/s00062-017-0660-2

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  • DOI: https://doi.org/10.1007/s00062-017-0660-2

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