Comaneci device-assisted embolization of wide-necked carotid aneurysms with an unfavorable ratio
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RESEARCH ARTICLE
Open Access
Comaneci device-assisted embolization of wide-necked carotid aneurysms with an unfavorable ratio Juan David Molina-Nuevo1,2* , Lorena López-Martínez1, María José Pedrosa-Jiménez1, Enrique Juliá-Molla1 and Francisco Hernández-Fernández3
Abstract Background: Endovascular treatment is the technique of choice for most intracranial aneurysms. However, the treatment of morphologically complex wide-necked aneurysms with an unfavorable anatomy is still a therapeutic challenge. The purpose of the study is to describe the initial experience with the Comaneci embolization assist device for the treatment of wide-necked aneurysms with an unfavorable ratio for direct embolization. Methods: We report a retrospective single-center analysis taken from a prospective database of consecutive aneurysms of the anterior circulation treated using the Comaneci device in the period from March 2017 to March 2019. Results: Eighteen aneurysms were collected from 16 patients (9 women and 7 men) treated using the Comaneci device. The mean age was 48.4 years (range 36–81). Twelve patients had SAH, three were incidental aneurysms and one had compressive symptoms. A complete asymptomatic occlusion rate of 88.8% was obtained. The major complication rate was 5.55%. Conclusion: The Comaneci embolization assist device is a safe, effective option for endovascular treatment of complex aneurysms with an unfavorable ratio. Keywords: Aneurysm, Comaneci, Remodeling, Embolization
Background Endovascular treatment is the technique of choice for most intracranial aneurysms [1, 2]. In cases with a complex or unfavorable anatomy, additional devices may be needed in order to achieve a complete and safe treatment of the aneurysm. Balloon-assisted coiling (BAC) involves placement of a removable compliant balloon adjacent to the aneurysm neck. Stent-assisted coiling * Correspondence: [email protected] 1 Radiology department, Complejo Hospitalario Universitario Albacete, Albacete, Spain 2 C. Hospitalario Universitario de Albacete, C. Hermanos Falcó nº 37. CP, 02006 Albacete, Spain Full list of author information is available at the end of the article
involves placement of a permanent stent that covers the neck of the aneurysm. Both techniques provide a scaffold that improves aneurysm neck coverage and at the same time prevents coil herniation into the parent vessel [3]. In this context, the Comaneci temporary embolization assist device (Rapid Medical, Yokneam, Israel) has appeared as a new tool for the treatment of intracranial aneurysms with an unfavorable anatomy. The main characteristics of this device include the ability to cover temporally the aneurysm neck allowing safe embolization using coils, without needing to administer antiaggregant treatment in the long term
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to t
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