How to use the nautilus intrasaccular system

The Nautilus intrasaccular system (EndoStream Medical, Israel) is a spiral-shaped neck-bridging endovascular device designed to support coiling of intracranial aneurysms [1-3]. It is deployed into the aneurysm sac through a 0.0165" or 0.017" microcatheter. Coils are delivered via a second microcatheter passed through the struts of the device. The system is available in 4-7-mm sizes and is entirely radio-opaque. It is mechanically detached and fully resheathable. Constructed from a nitinol wire with a platinum-based coil sleeve, it lacks a proximal marker. It has the lowest profile of current intrasaccular devices but a limited size range. Antiplatelet therapy is not mandatory. Limited published series and post-market data suggest high occlusion rates with low complication rates. The device may be particularly suitable for ruptured wide-necked aneurysms. This technical video discusses the device with the aid of two illustrative cases.