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  • E-203 The SEASE international registry analysis on the treatment of intracranial aneurysms with incorporated branch using cobalt-chromium 64 wires surpass evolve

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SNIS 21st annual meeting electronic poster abstracts
E-203 The SEASE international registry analysis on the treatment of intracranial aneurysms with incorporated branch using cobalt-chromium 64 wires surpass evolve
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  1. M Dibas1,
  2. J Vivanco-Suarez1,
  3. D Lopes2,
  4. R Hanel3,
  5. A Rodriguez-Calienes1,
  6. G Cortez3,
  7. J Fifi4,
  8. A Devarajan4,
  9. G Toth5,
  10. T Patterson5,
  11. D Altschul6,
  12. V Pereira7,
  13. X Liu8,
  14. A Puri9,
  15. A Kühn10,
  16. W Guerrero11,
  17. P Khandelwal12,
  18. I Bach12,
  19. P Kan13,
  20. G Edhayan13,
  21. M Martinez-Galdamez14,
  22. C Given15,
  23. B Gross16,
  24. S Narayanan17,
  25. M Galecio-Castillo1,
  26. S Derakhshani18,
  27. S Ortega-Gutierrez1
  1. 1Department of Neurology, The University of Iowa Hospitals and Clinics, Iowa City, IA
  2. 2Department of Neurosurgery, Brain and Spine Institute, Advocate Aurora Health, Park Ridge, IL
  3. 3Lyerly Neurosurgery, Baptist Neurological Institute, Jacksonville, FL
  4. 4Department of Neurological Surgery, Mount Sinai Health System, New York, NY
  5. 5Cerebrovascular Center, Neurological Institute, Cleveland Clinic, Cleveland, OH
  6. 6Department of Neurological Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
  7. 7Department of Neurosurgery, St Michael’s Hospital, Toronto, ON
  8. 8Department of Neurosurgery, St Michael’s Hospital, Toronto, ON, Canada
  9. 9Department of Radiology, University of Massachusetts Chan Medical School, Worcester, MA
  10. 10Department of Radiology, Division of Neurointerventional Radiology, University of Massachusetts Chan Medical School, Worcester, MA
  11. 11Department of Neurology, University of South Florida, Tampa, FL
  12. 12Department of Neurological Surgery, Robert Wood Johnson University Hospital, Newark, NJ
  13. 13Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX
  14. 14Department of Interventional Neuroradiology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
  15. 15Department of Radiology, Baptist Health Lexington, Lexington, KY
  16. 16Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA
  17. 17Pacific Neuroscience Institute, Santa Monica, CA
  18. 18Department of Diagnostic and Therapeutic Neuroradiology, Essex Center for Neurological Sciences, Queen’s University Hospital, Romford, Greater London, UK

Abstract

Introduction The use of the Pipeline Embolization Device for the treatment of intracranial aneurysms (IAs) with incorporated branch has been associated with delayed aneurysmal occlusion. However, there is limited evidence on the effectiveness of cobalt-chromium Surpass Evolve (SE; Stryker) for treating these types of IAs. This study aims to evaluate the efficacy and safety of SE for IAs with incorporated branch, and to compare outcomes between those with branch originating from the neck versus those arising from the sac of the aneurysms.

Methods This analysis utilizes data from the Safety and Effectiveness Assessment of the Surpass Evolve (SEASE) registry, comprising retrospective data from 15 academic institutions in North America and Europe. Only IAs with incorporated branch were included in the study. Patient characteristics, angiographic findings, and clinical outcomes were assessed for the overall dataset and stratified based on the location of branch emergence from the aneurysm.

Results The study included 67 patients (median [IQR] age: 58 years [51–66 years]) with IAs. Among these, 53 had branches emerging from the sac, while 14 had branches originating from the neck. Demographic characteristics, comorbidities, baseline functional status, and IA features were similar between the two groups (P > 0.05). Most IAs were located in the posterior communicating artery (46.3%), with a median size of 4.35 mm (IQR: 3.12, 6.51). At a median imaging follow-up of 10.5 months (IQR: 6.5–13.1 months), complete occlusion rates were lower in IAs with branch emerging from the sac (60.8%) compared to those with neck-originating branch (92.9%, P = 0.026), with an overall occlusion rate of 67.7%. The fate of the incorporated branch remained patent in 98.2% of cases at last follow-up, with no significant difference between the two groups (P > 0.999). Thromboembolic and hemorrhagic complications, as well as retreatment, were reported in 1.6% and 3.1% of cases, respectively, with no significant differences between the groups.

Conclusion The use of SE for IAs with incorporated branch demonstrates acceptable rates of occlusion and a favorable safety profile. Notably, better occlusion rates were observed in IAs with branch originating from the neck compared to those emerging from the sac. These findings underscore the importance of careful consideration regarding branch location prior to SE implantation. Further large-scale studies are warranted to validate these results.

Disclosures M. Dibas: None. J. Vivanco-Suarez: None. D. Lopes: 1; C; Mentice. 2; C; Asahi, Stryker, Corindus, Siemens, and Medtronic. 4; C; Syncron, Three Rivers Inc., Q’apel, VIZ.AI, Methinks, Vastrax, Borvo, BendIT, Collavidence, NDI, Prometheus, NextGen, Galaxy, Global Intervention, and Sim&Cure. 6; C; Honoraria: Cerenovus, Medtronic, and Stryker. Advisory Board: INFINITY [trial]. R. Hanel: 1; C; NIH, Interline Endowment, Microvention, Stryker, and CNX. 2; C; Medtronic, Stryker, Cerenovous, Microvention, Balt, Phenox, Rapid Medical, and Q’Apel. 4; C; InNeuroCo, Cerebrotech, eLum, Endostream, Three Rivers Medical Inc., Scientia, RisT, BlinkTBI, and Corindus. 6; C; Advisory board: MiVI, eLum, Three Rivers Medical Inc., Shape Medical, and Corindus. A. Rodriguez-Calienes: None. G. Cortez: None. J. Fifi: 1; C; Viz. 2; C; Penumbra, Stryker, Microvention, and Cerenovus. 4; C; Imperative care and Cerebrotech. A. Devarajan: None. G. Toth: 2; C; Medtronic and Dynamed. T. Patterson: None. D. Altschul: 2; C; Microvention, Stryker, and Von Vascular Inc. V. Pereira: 2; C; Stryker, Medtronic, Penumbra, Neurovasc, and Balt. X. Liu: None. A. Puri: 1; C; Medtronic, Stryker, and Cerenovus. 2; C; Medtronic, Stryker, Cerenovus, Microvention, Agile, Merit, Corindus, Q’apel, Arsenal, and Imperative Care. A. Kühn: None. W. Guerrero: None. P. Khandelwal: 2; C; Stryker and Medtronic. I. Bach: None. P. Kan: 1; C; NIH, Siemens, Joe Niekro, and Medtronic. 2; C; Stryker, Imperative Care, Cerenovus, and Microvention. G. Edhayan: None. M. Martinez-Galdamez: 2; C; Medtronic. C. Given: 2; C; Stryker and Medtronic. B. Gross: 2; C; Medtronic, Microvention, and Stryker. S. Narayanan: 2; C; Cerenovus, MicroVention, Inc. and Imperative Care. M. Galecio-Castillo: None. S. Derakhshani: None. S. Ortega-Gutierrez: 1; C; NIH-NINDS (R01NS127114–01, RO3NS126804–01), Stryker, Medtronic, Microvention, Methinks, Viz.ai. 2; C; Medtronic, Stryker Neurovascular.

https://doi.org/10.1136/jnis-2024-SNIS.308

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