Initial Experience with Surpass Evolve Flow Diverter in the Treatment of Intracranial Aneurysms
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ORIGINAL ARTICLE
Initial Experience with Surpass Evolve Flow Diverter in the Treatment of Intracranial Aneurysms V. Maus1
· W. Weber1 · A. Berlis2 · C. Maurer2 · S. Fischer1
Received: 4 August 2020 / Accepted: 17 October 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background and Purpose The principle of flow diversion has revolutionized the treatment of brain aneurysms. In this study, we report our experience of the new Surpass Evolve (SE) flow diverter in the treatment of intracranial aneurysms. Material and Methods Patients were treated with the SE as first-line therapy between May 2019 and June 2020 at 2 experienced institutions. Inclusion criteria were wide-necked, blister-like, or fusiform/dissecting aneurysms in the anterior and posterior circulation. Primary endpoint was technical success defined as favorable navigation to the target vessel and successful deployment of the SE. Secondary endpoints were favorable aneurysm occlusion defined as O’Kelly Marotta (OKM) scale C1-3 + D on follow-up, procedure-related complications and retreatment. Results A total of 46 aneurysms in 42 patients were treated with 57 SE flow diverters. Median aneurysm size was 6.6 mm (IQR 4.0–12.2 mm) with a median neck width of 4 mm (IQR 2.2–5.4 mm). On admission, 6 (13%) aneurysms were ruptured and 41 (89%) were located in the anterior circulation. The primary endpoint was reached in 96%. Median follow-up was 116 days (IQR 92–134 days) and available for 36/46 (78%) aneurysms. Favorable aneurysm occlusion was seen in 31/36 (86%) aneurysms and 27/36 (75%) were occluded completely. Parent artery occlusion appeared in 3 (3%) patients on follow-up and 2 aneurysms (6%) required additional treatment due to insufficient closure. Conclusion The new SE flow diverter is safe and seems to be effective with promising occlusion rates at short-term follow-up.
Keywords Endovascular treatment · Intracranial stenting · Flow diversion · Interventional neuroradiology · Aneurysm occlusion
Abbreviations AOR Aneurysm occlusion rate CT Computed tomography ICA Internal carotid artery IQR Interquartile range MRI Magnet resonance imaging mRS Modified Rankin scale OKM O’Kelly Marotta SAH Subarachnoid hemorrhage
V. Maus
[email protected] 1
Department of Diagnostic and Interventional Neuroradiology and Nuclear Medicine, Ruhr University, Knappschaftskrankenhaus Bochum, In der Schornau 23–25, 44892 Bochum, Germany
2
Department of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg, Augsburg, Germany
SE SS
Surpass Evolve Surpass Streamline
Introduction The use of flow diverters for intracranial aneurysms has introduced a new era of endovascular treatment. As the initial treatment approach was deployment of coils within the aneurysm sac, flow diversion enables exclusion of the aneurysm from blood circulation without intrasaccular manipulation. The blood flow is redirected in the parent artery away from the aneurysm and thereby inducing aneurysm thrombosis and reconstruction of the diseased ar
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