Treatment of Wide-Necked Bifurcation Aneurysms : Initial Results with the pCANvas Neck Bridging Device

Clin Neuroradiol. 2019 Sep;29(3):467-477. doi: 10.1007/s00062-018-0680-6. Epub 2018 Mar 19.

Abstract

Background: Recently, numerous devices dedicated to the treatment of wide-necked aneurysms have become available. We present our initial experience with the pCANvas device and present the technical success rate, clinical outcome and immediate angiographic occlusion rates.

Objective: We sought to determine the efficacy of flow with the pCANvas for the treatment of unruptured intracranial aneurysms.

Methods: We performed a retrospective review of our prospectively collected data to identify patients treated with the pCANvas device between February 2015 and February 2017. The patient demographics, aneurysm characteristics, immediate and delayed clinical and radiographic follow-up data were recorded.

Results: We identified 17 patients (13 female) treated only with the pCANvas device. The average age of the patients was 60.5 ± 13.3 years (range 25-75 years). The average dome width was 7.6 ± 3.2 mm (range 3-15.8 mm), dome height 7.1 ± 3.2 mm (range 3-12.9 mm) and neck width 5.4 ± 3.2 (range 3-16.3 mm). The average aspect ratio was 1.5 ± 0.8 (range 0.6-3.7). At the end of the procedure 15 aneurysms continued complete filling of the aneurysm (Raymond Roy Classification[RRC] 3) with 2 aneurysms showing only filling of the neck of the aneurysm (RRC 2). Early follow-up angiography was available for 16 patients and at this stage 11 aneurysms showed persistent and complete filling of the aneurysm (RRC 3), 5 aneurysms showed complete occlusion of the aneurysm (RRC 1) and 7 aneurysms underwent repeat treatment with coiling.

Conclusion: The early results on the use of the pCANvas are promising; however, longer term follow-up and larger studies are required.

Keywords: Aneurysm; Bifurcation; Stent; Wide neck; pCANvas.

MeSH terms

  • Adult
  • Aged
  • Cerebral Angiography
  • Cerebrovascular Circulation
  • Endovascular Procedures / instrumentation*
  • Endovascular Procedures / methods
  • Female
  • Humans
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / pathology
  • Intracranial Aneurysm / physiopathology
  • Intracranial Aneurysm / therapy*
  • Male
  • Medical Illustration
  • Middle Aged
  • Regional Blood Flow
  • Retreatment / instrumentation
  • Retreatment / methods
  • Retrospective Studies
  • Stents
  • Treatment Outcome