Introduction/Purpose Flow diverting stents (FDS) have been established as the primary treatment modality for large and giant extradural ICA aneurysms. The SCENT study, which is the largest prospective FDS study to date, demonstrated the safety and efficacy of the Surpass Streamline™ FDS with the goal of utilizing a single-FDS strategy. We sought to compare both the long-term occlusion rates of extradural ICA aneurysms treated in SCENT and the number of FDS used with the published results of the PUFS (Pipeline) study.

Materials and Methods We performed a retrospective subgroup analysis of the prospective multi-center SCENT study dataset. We identified all subjects who had an extradural aneurysm treated and identified the demographics, procedural characteristics, and occlusion rates of those available for 36-month follow-up. These results were compared with the published long-term results of the PUFS study using Fisher’s Exact Test.

Results Of the 180 subjects treated in SCENT, 56 had an extradural aneurysm (mean age = 62.9 ± 10.2 years, 94.6% female, 26.8% current smoker). These aneurysms were primarily saccular (48/56, 85.7%) and measured on average 17.4 ± 7.3 mm. Technical success of the index procedure was achieved in 55/56 patients (98.2%). Each SCENT study treatment required on average 1.2 ± 0.5 Surpass FDS as compared to the 105/107 patients treated in PUFS who received multiple devices (mean Pipelines implanted 3, range 1-15). Long-term (36-month) angiographic results from SCENT demonstrated adequate occlusion (Raymond 1 or 2) in 34/35 (97.1%) of aneurysms available for follow-up. This rate of occlusion was nearly identical to the 36-month rate of adequate occlusion from the PUFS study (73/75 aneurysms, 97.3%, p=0.687).

Conclusion The Surpass Streamline™ FDS provides comparable long-term efficacy to the Pipeline embolization device for extradural ICA aneurysms with the benefit of a cost-effective single-FDS technique.

Disclosures A. Coon: 2; C; Stryker, Medtronic, Microvention, InNeuroCo, Imperative, Rapid, Cerenovus. J. Campos: None. P. Meyers: 2; C; Stryker, Medtronic, Penumbra. P. Kan: 2; C; Stryker, Cerenovus. 4; C; InNeuroCo. P. Taussky: None. A. Wakhloo: 1; C; Philips Medical. 2; C; Stryker, Phenox. 3; C; SCENT Trial. 4; C; InNeuroCo, EpiEP, Neural Analytics, Rist, Analytics 4 Life, ThrombX. R. Hanel: 1; C; NIH, Interline Endowment, Microvention, Stryker, CNX. 2; C; Stryker, Medtronic, Cerenovus, Microvention, Balt, Phenox, Rapid Medical, Q’Apel. 4; C; InNeuroCo, Cerebrotech, eLum, Endostream, Three Rivers Medical Inc., Scientia, RIST, BlinkTBI, Corindus. 6; C; Advisory board for MiVl, Advisory board for eLum, Advisory board for Three Rivers, Advisory board for Shape Medical, Advisory board for Corindus.