The pCONus Device in Treatment of Wide-necked Aneurysms : Technical and Midterm Clinical and Angiographic Results.

Abstract

Avariety of devices for treatment of wide-necked bifurcation aneurysms are emerging. Here we report our results using the new pCONus device with special emphasis on the morphological and anatomical requirements for successful implantation. In this study we treated 21patients with 22aneurysms by endovascular interventions. After providing informed consent, patients were included according to the following criteria: aneurysm dome to neck ratio <2 or neck diameter >4mm. The primary end points for clinical safety were the absence of death, absence of major or minor stroke and absence of transient ischemic attack. A total of 22 aneurysms in 21patients were treated with pCONus-assisted coiling. In 19patients harboring 20aneurysms the implantation of the device was successful and these aneurysms showed an adequate occlusion after 6months in 95 %. The complication rate was low (5 %) with one case of minor neurological stroke. Analysis of the data showed that the difference in aneurysm angulation between successful (mean45°) and failed implantations (mean71.5°) was highly significant. Use of the pCONus device and coiling in wide-necked bifurcation aneurysms is safe and provides good occlusion rates but might be limited by the angulation between the aneurysm and the parent vessel.