Background Endovascular treatment of intracranial aneurysms using detachable microcoils is among the most effective methods for excluding aneurysms from the circulation. Auxiliary procedures allow one to significantly increase the radicality of embolization, especially for wide-necked aneurysms.
Objective To evaluate the effectiveness and safety of the Comaneci device in endovascular treatment of intracranial aneurysms using microcoils.
Materials and Methods Twelve unruptured intracranial aneurysms in 10 patients were embolized with the Comaneci device at the National Medical Research Center named after Academician E.A. Meshalkin in October–December, 2019 (including two (16.7%) AVM-associated proximal flow-related aneurysms in one patient). All the aneurysms were located in the carotid basin; the dome-to-neck ratio was <2.
Results The technical success of embolization was achieved in all the cases. Total embolization (class I according to the Raymond–Roy Occlusion Classification) was observed in 11 (91.7%) cases. One (8.3%) patient had incomplete occlusion (class IIIb according to the Raymond–Roy Occlusion Classification). In one (8.3%) case, a single coil turn prolapsed into the mother vessel lumen when the device was removed, so a stent had to be inserted. The disability and mortality rates were 0%.
Conclusions Our primary experience of using the Comaneci device demonstrates that it allows one to achieve good angiographic and clinical outcomes during endovascular treatment of wide-necked intracranial aneurysms, thus being a good alternative to balloon- and stent-assisted coiling procedures. However, the study needs to be continued to evaluate safety of this device and the long-term outcomes of treatment.
Disclosures K. Orlov: None. N. Strelnikov: None. V. Berestov: None.
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