Morphological factors and device deformation associated with recurrence in intracranial aneurysms treated with the contour neurovascular system

The Contour Neurovascular Device is an intrasaccular flow disrupting device designed for the treatment of wide-neck intracranial aneurysms and has been shown to be a safe and effective treatment option. Mid- and long-term results are still scarce, and data on morphological risk factors and device deformation have not been published yet. In this study, we investigate the association of aneurysm-related morphologic parameters and device deformation with recurrence after treatment of intracranial aneurysms with Contour.

All patients with unruptured and ruptured aneurysms that were treated with Contour in our institution were retrospectively identified. Only patients with 3D-rotational angiography, flat-panel detector-CT or CTA on pre-interventional, 24 h post-interventional, and at least one follow-up imaging were included. Morphological parameters and Contour deformation on longitudinal imaging were tested for an association with aneurysm occlusion status.

63 aneurysms were analyzed, the median follow-up time was 17 (range, 2-67) months. Adequate occlusion (BOSS 0-2) on longest follow-up occurred in 79 %, and Contour deformation in 57 %. The parameters neck diameter (p = 0.005, OR 3.1), Contour migration (p = 0.017, OR 9.3) and lateral impression (p = 0.033, OR 5) were significantly and independently associated with deterioration of occlusion status on follow-up imaging. Deformation mostly occurred within a 4 to 6-month follow-up period.

Larger neck diameter and Contour deformation are significantly associated with recurrence after treatment with Contour irrespective of the dome-neck ratio. Assessment of Contour deformation on 3D follow-up imaging seems advisable.