Treatment of wide-necked bifurcation aneurysms with the eCLIPs device: 5-year experience of a single center.


Journal

Journal of neurointerventional surgery
ISSN: 1759-8486
Titre abrégé: J Neurointerv Surg
Pays: England
ID NLM: 101517079

Informations de publication

Date de publication:
May 2023
Historique:
received: 26 01 2022
accepted: 08 04 2022
medline: 17 4 2023
pubmed: 12 5 2022
entrez: 11 5 2022
Statut: ppublish

Résumé

The endovascular clip system (eCLIPs) is a novel device with both neck bridging and flow-diversion properties that make it suitable for the treatment of wide-necked bifurcation aneurysms. To describe the clinical and radiologic outcomes of the eCLIPs device, including the first-in-man use of the latest version of the device. This is a retrospective case series on all the wide-necked bifurcation aneurysms treated with the eCLIPs device in our center. The immediate and latest radiologic and clinical outcomes were assessed. The device was successfully implanted in 12 of 13 patients. After a median follow-up period of 19 months (range 3-64 months), all patients with available data (11/12) had a good radiologic outcome (modified Raymond-Roy classification scores of 1 or 2). Two patients (18.2%) underwent re-treatment with simple coiling through the device. One of these had a subarachnoid hemorrhage prior to re-treatment. There were no major complications (death or permanent neurologic deficits) associated with use of the device. Our series demonstrates occlusion rates that are similar to those of standard stent-assisted coiling and intrasaccular flow diversion for wide-necked bifurcation aneurysms. Larger registry-based studies are necessary to support our findings.

Sections du résumé

BACKGROUND BACKGROUND
The endovascular clip system (eCLIPs) is a novel device with both neck bridging and flow-diversion properties that make it suitable for the treatment of wide-necked bifurcation aneurysms.
OBJECTIVE OBJECTIVE
To describe the clinical and radiologic outcomes of the eCLIPs device, including the first-in-man use of the latest version of the device.
METHODS METHODS
This is a retrospective case series on all the wide-necked bifurcation aneurysms treated with the eCLIPs device in our center. The immediate and latest radiologic and clinical outcomes were assessed.
RESULTS RESULTS
The device was successfully implanted in 12 of 13 patients. After a median follow-up period of 19 months (range 3-64 months), all patients with available data (11/12) had a good radiologic outcome (modified Raymond-Roy classification scores of 1 or 2). Two patients (18.2%) underwent re-treatment with simple coiling through the device. One of these had a subarachnoid hemorrhage prior to re-treatment. There were no major complications (death or permanent neurologic deficits) associated with use of the device.
CONCLUSION CONCLUSIONS
Our series demonstrates occlusion rates that are similar to those of standard stent-assisted coiling and intrasaccular flow diversion for wide-necked bifurcation aneurysms. Larger registry-based studies are necessary to support our findings.

Identifiants

pubmed: 35545426
pii: neurintsurg-2022-018731
doi: 10.1136/neurintsurg-2022-018731
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

461-464

Informations de copyright

© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: TRM is a principal of eVasc Neurovascular, manufacturers of the eCLIPs. JDBD is currently on the editorial board of JNIS as a fellow of the JNIS.

Auteurs

Jose Danilo Bengzon Diestro (JDB)

Division of Diagnostic and Therapeutic Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada danni.diestro@gmail.com.

Michael B Keough (MB)

Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.

Robert A Ashforth (RA)

Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.

Michael M Chow (MM)

Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.

Jeremy L Rempel (JL)

Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta, Canada.

Thomas R Marotta (TR)

Division of Diagnostic and Therapeutic Neuroradiology, Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.

Cian O'Kelly (C)

Division of Neurosurgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.

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