Embolization of Ruptured and Unruptured Aneurysms with the Contour Neurovascular System-Summary of 106 Cases.

Abstract

Background and purpose: Aneurysmal disease of the intracranial vasculature poses a relevant threat, warranting effective interventions. Minimally invasive interventional techniques for aneurysm treatment have evolved to the application of flow-diversion stents and devices. This study focuses on the Contour Neurovascular System (CNS), aiming to add knowledge regarding its mid- to long-term outcomes in treating wide-necked intracranial aneurysms.

Materials and methods: Conducted in accordance with STROBE guidelines, this study retrospectively evaluated all patients with intracranial aneurysms treated with CNS embolization. Demographic and interventional data were collected retrospectively, including aneurysm characteristics, procedural details, and angiographic follow-up evaluations up to 24 months after CNS implantation.

Results: A total of 106 patients with 109 aneurysms were included in this study, whereby 72 patients were treated for an incidental aneurysm, while 34 patients presented with subarachnoid hemorrhage. Implantation was successful in 95.5% of patients. Occlusion rates were as follows: 6 months (69/106, 65.1%): Raymond-Roy-Scale (RRS) 1 44/69 (63.4%), RRS 2 16/69 (23.1%), RRS 3a 4/69 (5.8%), RRS 3b 5/69 (7.2%); 12 months (44/106, 41.5%): RRS 1 24/44 (55.5%), RRS 2 12/44 (27.3%), RRS 3a 4/44 (9.0%), RRS 3b 4/44 (9.0%); 24 months (30/106, 28.3%): RRS 1 21/30 (70.0%), RRS 2 8/30 (26.7%), RRS 3b 1/30 (3.3%). Periprocedural complications: Overall 8/106 (7.5%); elective cases 4/72 (5.5%); aneurysm rupture 4/34 (11.7%). Adjunctive devices were used in 13/106 cases (12.2%).

Conclusions: The present work reports the long-term angiographic and clinical follow-up results of a single-center cohort of 106 patients with intracranial aneurysms treated with the CNS. The CNS demonstrated a high rate of successful implantation and promising mid- and long-term stability, with a low reintervention rate beyond 24 months in patients exhibiting early occlusion at 6 months. While acknowledging the limitations, these findings contribute valuable information about the safety and efficacy of the CNS, and warrant continued exploration in larger, prospective studies to validate its role in aneurysm treatment.