期刊
JOURNAL OF CLINICAL MEDICINE
卷 11, 期 3, 页码 -出版社
MDPI
DOI: 10.3390/jcm11030884
关键词
coiling; endovascular treatment; intracranial aneurysms; pCONUS; stent-assisted coiling; wide-neck bifurcation aneurysms
Coil embolization is a well-established treatment for intracranial aneurysms, but wide-neck bifurcation aneurysms (WNBAs) remain challenging. The pCONUS, a stent-like implant, has shown to be a safe and effective option for the treatment of WNBAs, with acceptable rates of aneurysm occlusion and low risks of adverse neurologic events.
Coil embolization has become a well-established option for the treatment of intracranial aneurysms. Yet, wide-neck bifurcation aneurysms (WNBAs) remain a challenge. The pCONUS is the first generation of a stent-like implant for the bridging of WNBAs to enable coiling. The pToWin study was a prospective, single-arm, multicenter study conducted to analyze the safety and efficacy of the pCONUS in the treatment of WNBAs. The primary effectiveness endpoint was the rate of adequate occlusion of the aneurysm at 3-6 and 7-12 months. The primary safety endpoint was the occurrence of major ipsilateral stroke or neurological death during the follow-up. A total of 115 patients were included. Aneurysm locations were the middle cerebral artery in 52 (45.2%), the anterior communicating artery in 35 (30.4%), the basilar artery in 23 (20%), the internal carotid artery terminus in three (2.6%), and the pericallosal artery in two (1.7%) patients. Treatment was successfully performed in all but one patient. The morbi-mortality rate was 1.9% and 2.3% at 3-6 and 7-12 months, respectively. Of the aneurysms, 75.0% and 65.6% showed adequate occlusion at 3-6 and 7-12 months, respectively. pCONUS offers a safe and reasonably effective treatment of WNBAs, demonstrated by acceptable adequate aneurysm occlusion and low rates of adverse neurologic events.
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