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Long-Term Outcomes of Temporary Stent-Assisted Coil Embolization for the Treatment of Intracranial Aneurysms Using
Jakub Onikijuk1, Adrian Rogala1,2, Kazimierz Kordecki1,3
1Department of Neurosurgery, Brodnowski Masovian Hospital, Warsaw, Poland.
Background And Objectives:
Comaneci is temporary embolization assist tool for the treatment of intracranial aneurysms (IAs). The device enables temporarily cover the aneurysm neck with maintaining the blood flow during the procedure. This factor contributes to safe embolization using coils. The study presents the long-term outcomes of temporary stent-assisted coil embolization of IAs using the Comaneci device.
Methods:
The analysis included 100 consecutive patients with incidental compressive and ruptured IAs. Qualification for the treatment with the Comaneci device was a wide-neck aneurysm defined as an IA with a neck width ≥4 mm or a dome-to-neck ratio of <2. Angiographic follow-ups were conducted 3 and 6 months, 1 year, and 18 months postprocedure, with the modified Raymond-Roy classification.
Results:
The patients were treated with: classic Comaneci devices (n = 35), Comaneci 17 devices (n = 60), and Comaneci Petit devices (n = 5). In 97 cases, bridging an aneurysmal neck was successful. At 18 months postprocedure, adequate occlusion (Raymond-Roy 1 + 2) was in 90 patients. Ten patients experienced recanalization of the aneurysm sack (Raymond-Roy 3) and were qualified for a flow diverter stent implantation. The Comaneci device was successfully deployed in all cases.
Conclusion:
The use of the Comaneci device has a low risk of complications in endovascular treatment of IAs, without procedure-related morbidity and mortality.
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