1Adrien Guenego

1Erasme Hospital

Background:

Wide-neck bifurcation aneurysms (WNBA) remain challenging for the neurointerventionist and/or neurosurgeon despite many recent advances. The pCONus (Phenox, Bochum, Germany) is an emerging device for endovascular neck protection, we report the first long-term results of this device.

Material(s) and Method(s):

We performed a retrospective analysis of all consecutive intracranial WNBA treated with the pCONus. Patients’ characteristics were reviewed, procedural complications, angiographic (Roy-Raymond scale) and clinical outcomes were documented.

Result(s): Discussion

Between January 2016 and September 2019, 43 patients (74% female, median age 56 [49-66] years) with 43 WNBA (mean width of 6.8+/-2.1mm, dome/neck ratio of 1.3+/-0.2 and neck of 5.2+/-1.3mm) were included. A procedural angiographic complication was reported in 5 patients (12%), no patient presented a post-operative neurological deficit or long-term complication, mortality rate was 0%. At last follow-up (median of 46.5 months [38.3-51.7]), an adequate occlusion (complete and neck remnant) was observed in 37/43 patients (86%) and an aneurysm remnant in 6/43 (14%). Four patients (9%) needed retreatment. No in-stent stenosis or branch occlusion were depicted.

Conclusion(s):

pCONus device provides a safe and efficient alternative for endovascular wide-neck bifurcation aneurysms management, with long-term stability.