RT Journal Article SR Electronic T1 First clinical experience with the new Surpass Evolve flow diverter: technical and clinical considerations JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 974 OP 980 DO 10.1136/neurintsurg-2019-015734 VO 12 IS 10 A1 Emanuele Orru A1 Henry Rice A1 Laetitia De Villiers A1 Jesse M Klostranec A1 Ajay K Wakhloo A1 Alexander L Coon A1 Ivan Radovanovic A1 Hans Kortman A1 Kartik Dev Bhatia A1 Timo Krings A1 Vitor M Pereira YR 2020 UL http://jnis.bmj.com/content/12/10/974.abstract AB Objective To describe the results in patients treated with the Surpass Evolve (SE) device, the new generation of Surpass flow diverters.Methods Twenty-five consecutive patients (20 women, average age 58 years), with anterior or posterior circulation aneurysms treated with SEs in two early-user centers, were included. Device properties and related technical properties, imaging and clinical follow-up data, and intraprocedural, early (<30 days) and delayed (>30 days) neurological complications, further divided into minor (silent/non-permanent) and major (permanent) complications, were recorded and analyzed.Results Twenty-nine SEs were successfully implanted in all subjects to treat 26 aneurysms using an 0.027" microcatheter with an average of 1.2 stents per patient. No intraprocedural thromboembolic or hemorrhagic complications were seen. At clinical follow-up, 24/25 (96%) patients had a modified Rankin Score of 0–2. Mortality was 0%. Imaging follow-up, available in 22/25 (88%) patients (median follow-up time 4 months), showed a complete aneurysm occlusion in 13/23 (57%) imaged lesions. Minor, transitory neurological deficits were recorded in 5/25 (20%) patients. One (4%) major complication was seen in one patient (4%) with a left-sided hemispheric stroke on postprocedural day 4 due to an acute stent thrombosis.Conclusions Preliminary experience in patients demonstrates a good performance of the SE. This newly designed implant maintains the engineering characteristics of Surpass flow diverters, including precise placement due to its lower foreshortening and a high mesh density, yet can be deployed through a significantly lower-profile delivery system.