Background Endovascular treatment of wide-necked aneurysms remains challenging without the use of adjunctive devices to preserve the parent artery.
Objective To present our initial experience with a temporary bridging device, the Comaneci (Rapid Medical, Israel). The compliant remodeling mesh protects the parent artery during coil occlusion without flow arrest in the distal vasculature. Permanent dual antiplatelet therapy is not required since the device is fully removed at the end of the procedure.
Methods All intracranial aneurysms treated by coil occlusion with the Comaneci device between December 2014 and November 2015 were included. Angiographic and clinical results were retrospectively analysed, including follow-up examinations. All aneurysms were unruptured.
Results 18 aneurysms of the internal carotid artery were included. Successful coil occlusion assisted by the Comaneci device as intended was possible in 14 cases (77.8%). Insufficient coverage of the aneurysmal neck was observed in four cases (22.2%), with modification of the treatment to stent-assisted coiling or remodeling. One clinically relevant complication occurred (5.6%).
Conclusions Our initial experience shows that use of the Comaneci device is straightforward for the treatment of selected wide-necked aneurysms. Further studies with long-term follow-up data are needed to identify the significance of the presented technique in the neurointerventional armamentarium.
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Preliminary data from this series were presented during the 2016 ABC-WIN seminar in Val d′Isere/France and during the 2016 annual meeting of the German Society of Neurosurgery in Frankfurt/Germany.
Contributors SF: conception and design of the work, data acquisition, analysis and interpretation, writing of the manuscript. AW and AC: critical review of the work. FD and FG: data acquisition, critical review of the work. WW: conception and design of the work, final approval of the manuscript.
Competing interests SF: support for travel to meetings—travel expenses for the meeting of the German Society of Neurosurgery 2016.
Ethics approval Ethics committee of Ruhr University Bochum, Germany.
Provenance and peer review Not commissioned; externally peer reviewed.
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