Safety and efficacy of the Contour Neurovascular System for treating intracranial aneurysms: a systematic review and meta-analysis.

Abstract

Background: The Contour Neurovascular System (CNS, Stryker, Kalamazoo, MI) has a unique design that allows it to address various aneurysm morphologies, including wide-necked, irregular, and shallow-shaped lesions. However, evidence of its safety and efficacy remains limited. This systematic review and meta-analysis synthesizes the current data on CNS performance.

Methods: A comprehensive search guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) standards was performed across PubMed, Embase, and Web of Science, including studies with ≥5 patients reporting on CNS use. Efficacy outcomes included immediate and last follow-up adequate aneurysm occlusion and technical success. Safety outcomes included good functional outcome (modified Rankin Scale (mRS) score of 0-2 at last follow-up), procedure-related morbidity (permanent neurological deficits), procedure-related mortality, intraoperative and postoperative complications. Pooled analyses with 95% confidence intervals (CI) were conducted, with heterogeneity assessed using I² statistics, and a random-effects model was applied.

Results: Nine studies, including 483 patients (58.8% female; mean age: 59.3±15.6 years) with 484 aneurysms, were analyzed. Of the 467 patients in whom rupture status was reported, 81.8% presented with unruptured aneurysms and 18.2% with ruptured aneurysms. Immediate adequate aneurysm occlusion rate was 53% (95% CI: 1% to 100%), with follow-up adequate occlusion at 93% (95% CI: 88% to 97%) and technical success at 98% (95% CI: 95% to 100%). Intraoperative and postoperative complication rates were 3% (95% CI: 0% to 7%) and 7% (95% CI: 3% to 12%), respectively. Procedure-related morbidity was 2% (95% CI: 0% to 3%), with no procedure-related mortality.

Conclusion: The CNS is a safe and effective novel intrasaccular device for treating intracranial aneurysms.