Early clinical experience with Cascade: a novel temporary neck bridging device for embolization of intracranial aneurysms.
Adult
Aged
Aneurysm, Ruptured
/ diagnostic imaging
Blood Vessel Prosthesis
/ adverse effects
Embolization, Therapeutic
/ adverse effects
Female
Humans
Intracranial Aneurysm
/ diagnostic imaging
Male
Middle Aged
Prospective Studies
Retrospective Studies
Self Expandable Metallic Stents
/ adverse effects
Treatment Outcome
aneurysm
device
embolization
subarachnoid hemorrhage
Journal
Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
31
07
2019
revised:
27
08
2019
accepted:
02
09
2019
pubmed:
23
9
2019
medline:
5
8
2020
entrez:
23
9
2019
Statut:
ppublish
Résumé
Temporary placement of a retrievable neck bridging device, allowing parent vessel flow, is an attractive alternative to balloon remodeling for treatment of ruptured intracranial aneurysms. To present, in a single-center study, our initial experience with Cascade (Perflow, Israel) in the treatment of ruptured intracranial aneurysms. During a period of 1.5 months, 12 patients with aneurysmal subarachnoid hemorrhage underwent coil embolization in conjunction with Cascade in our center. Retrospective analysis of prospectively collected angiographic and clinical data was conducted to assess the safety and efficacy of the device. Among all treated patients, 41.7% (5/12) were female, the median age was 55 (47-77) years, the median aneurysm dome size was 5.75 mm (3-9.1), and the median neck size was 3.55 mm (2.3-7.9). Complete obliteration (Raymond 1) was achieved in 75% (9/12) of cases, and intentional residual neck (Raymond 2) was left in three cases (25%). None of the patients received any oral or intravenous antiplatelet therapy perioperatively. No thromboembolic complications, device-related spasm, vessel perforation, or coil entanglement were detected in any of the treated patients. In our initial experience, treatment of wide-neck ruptured intracranial aneurysms with Cascade is safe and effective, without the need for adjuvant antiplatelet therapy. Long-term follow-up data in larger cohorts are needed to confirm these preliminary findings.
Sections du résumé
BACKGROUND
BACKGROUND
Temporary placement of a retrievable neck bridging device, allowing parent vessel flow, is an attractive alternative to balloon remodeling for treatment of ruptured intracranial aneurysms.
OBJECTIVE
OBJECTIVE
To present, in a single-center study, our initial experience with Cascade (Perflow, Israel) in the treatment of ruptured intracranial aneurysms.
METHODS
METHODS
During a period of 1.5 months, 12 patients with aneurysmal subarachnoid hemorrhage underwent coil embolization in conjunction with Cascade in our center. Retrospective analysis of prospectively collected angiographic and clinical data was conducted to assess the safety and efficacy of the device.
RESULTS
RESULTS
Among all treated patients, 41.7% (5/12) were female, the median age was 55 (47-77) years, the median aneurysm dome size was 5.75 mm (3-9.1), and the median neck size was 3.55 mm (2.3-7.9). Complete obliteration (Raymond 1) was achieved in 75% (9/12) of cases, and intentional residual neck (Raymond 2) was left in three cases (25%). None of the patients received any oral or intravenous antiplatelet therapy perioperatively. No thromboembolic complications, device-related spasm, vessel perforation, or coil entanglement were detected in any of the treated patients.
CONCLUSIONS
CONCLUSIONS
In our initial experience, treatment of wide-neck ruptured intracranial aneurysms with Cascade is safe and effective, without the need for adjuvant antiplatelet therapy. Long-term follow-up data in larger cohorts are needed to confirm these preliminary findings.
Identifiants
pubmed: 31542724
pii: neurintsurg-2019-015338
doi: 10.1136/neurintsurg-2019-015338
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
303-307Informations de copyright
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.