RT Journal Article
SR Electronic
T1 Endovascular treatment of wide-necked intracranial aneurysms using the Nautilus Intrasaccular System: initial case series of 41 patients at a single center
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP jnis-2022-019295
DO 10.1136/jnis-2022-019295
A1 Alexander Sirakov
A1 Pervinder Bhogal
A1 Kristina Sirakova
A1 Marin Penkov
A1 Krasimir Minkin
A1 Kristian Ninov
A1 Hristo Hristov
A1 Asen Hadzhiyanev
A1 Vasil Karakostov
A1 Stanimir Sirakov
YR 2022
UL http://jnis.bmj.com/content/early/2022/10/19/jnis-2022-019295.abstract
AB Background Endovascular treatment of intracranial wide-necked and bifurcation aneurysms (WNBA) is technically challenging. The Nautilus Intrasaccular System is designed to provide a mechanical barrier at the aneurysm neck to support coil embolization. We report the results of a single-center series of patients treated for intracranial aneurysms with the Nautilus.Methods Clinical and radiological data were retrospectively collected for all patients treated with the Nautilus for an unruptured or ruptured intracranial aneurysm at our center between March 2021 and March 2022. Clinical outcomes (modified Rankin Scale (mRS) scores), Raymond–Roy angiographic occlusion, recanalization, and complications were measured immediately post-procedure and at 3–6-month follow-up.Results A total of 41 patients of mean age 56.7 years (range 37–83 years) were treated with the Nautilus, with 41 saccular aneurysms (18 (43.9%) unruptured and 23 (56.1%) ruptured). The majority of aneurysms (39/41 (95.1%)) were located in the anterior circulation. We experienced no technical complications. One patient had an asymptomatic post-procedural minor stroke related to the procedure. Immediate Class I occlusion was achieved in 30 (73.1%) patients. The rate of all-cause mortality was 7.3% (3/41). One patient was lost to follow-up. At follow-up, 94.5% (35/37) of patients achieved Class I occlusion and 94.5% (35/37) had an mRS score of 0. There were no procedural-related deaths or permanent morbidities at discharge or follow-up.Conclusion This study demonstrates good safety and effectiveness using the Nautilus Intrasaccular System to treat both ruptured and unruptured intracranial aneurysms. Larger studies are needed to confirm these findings.Data are available upon reasonable request.