The LUNA aneurysm embolization system for intracranial aneurysm treatment: short-term, mid-term and long-term clinical and angiographic results

被引:44
作者
Piotin, Michel [1 ]
Biondi, Alessandra [2 ]
Sourour, Nader [3 ]
Mounayer, Charbel [4 ]
Jaworski, Maciej [5 ]
Mangiafico, Salvatore [6 ]
Andersson, Tommy [7 ]
Soderman, Michael [7 ]
Goffette, Pierre [8 ]
Anxionnat, Rene [9 ]
Blanc, Raphael [1 ]
机构
[1] Fdn Rothschild Hosp, Dept Intervent Neuroradiol, Paris, France
[2] CHU Besancon, Dept Neuroradiol & Endovasc Therapy, Besancon, France
[3] CHU Pitie Salpetriere, Dept Intervent Neuroradiol, Paris, France
[4] CHU Limoges, Dept Intervent Neuroradiol, Limoges, France
[5] Med Univ Warsaw, Dept Radiol 2, Warsaw, Poland
[6] Careggi Univ Hosp, Dept Intervent Neuroradiol, Florence, Italy
[7] Karolinska Univ Hosp Solna, Dept Neuroradiol, Stockholm, Sweden
[8] Catholic Univ Louvain, Clin Univ St Luc, Dept Neuroradiol, Brussels, Belgium
[9] CHU Nancy, Dept Neuroradiol, Nancy, France
关键词
aneurysm; endovascular procedures; flow disruption; LUNA device; BARE PLATINUM COILS; ENDOVASCULAR TREATMENT; BRAIN-ABSCESS; FOLLOW-UP; WEB; RECURRENCES; DEVICE;
D O I
10.1136/neurintsurg-2018-013767
中图分类号
R445 [影像诊断学];
学科分类号
100207 ;
摘要
Background and purpose Intrasaccular aneurysm flow disruption represents an emerging endovascular approach to treat intracranial aneurysms. The purpose of this study was to determine the clinical and angiographic outcomes of using the LUNA aneurysm embolization system (AES) for treatment of intracranial aneurysms. Materials and methods The LUNA AES Post-Market Clinical Follow-Up study is a prospective, multicenter, single-arm study that was designed to evaluate device safety and efficacy. Bifurcation and sidewall aneurysms were included. Aneurysm occlusion was assessed using the Raymond-Roy classification scale. Disability was assessed using the Modified Rankin Scale (mRS). Morbidity was defined as mRS >2 if baseline mRS <= 2, increase in mRS of 1 or more if baseline mRS >2, or mRS >2 if aneurysm was ruptured at baseline. Clinical and angiographic follow-up was conducted at 6, 12 and 36 months. Results Sixty-three subjects with 64 aneurysms were enrolled. Most aneurysms were unruptured (60/63 (95.2%)); 49 were bifurcation or terminal (49/64 (76.6%)). Mean aneurysm size was 5.6 +/- 1.8 mm (range, 3.6-14.9 mm), and mean neck size was 3.8 +/- 1.0 mm (range, 1.9-8.7 mm). Though immediate postoperative adequate occlusion was low (11/63, 18%), adequate occlusion was achieved in 78.0% (46/59) and 79.2% (42/53) of the aneurysms at 12 months and 36 months, respectively. Four patients were retreated by the 12-month follow-up (4/63 (6.3%)) and three patients were retreated by the 36-month follow-up (3/63 (4.8%)). There were two major strokes (2/63 (3.2%)), one minor stroke (1/63 (1.6%)) and three incidents of intracranial hemorrhage in two subjects (2/63 (3.2%)) prior to the 12-month follow-up. There was one instance of mortality (1/63, 1.6%). Morbidity was 0% (0/63) and 1.8% (1/63) at the 12-month and 36-month follow-ups, respectively. Conclusions LUNA AES is safe and effective for the treatment of bifurcation and sidewall aneurysms. Clinical trial registration ; Results .
引用
收藏
页数:8
相关论文
共 26 条
[1]  
Al-Okaili R, 2002, AM J NEURORADIOL, V23, P697
[2]   Transcirculation Endovascular Treatment of Complex Cerebral Aneurysms: Technical Considerations and Preliminary Results [J].
Albuquerque, Felipe C. ;
Gonzalez, L. Fernando ;
Hu, Yin C. ;
Newman, C. Benjamin ;
McDougall, Cameron G. .
NEUROSURGERY, 2011, 68 (03) :820-829
[3]   WEB in Partially Thrombosed Intracranial Aneurysms: A Word of Caution [J].
Anil, G. ;
Goddard, A. J. P. ;
Ross, S. M. ;
Deniz, K. ;
Patankar, T. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2016, 37 (05) :892-896
[4]   Brain abscess after endosaccular embolisation of a cerebral aneurysm [J].
Chen, Guangzhong ;
Zhan, Shengquan ;
Chen, Wei ;
Li, Zhaojie ;
Zhou, Dong ;
Zeng, Shaojian ;
Lin, Xiaofeng ;
Tang, Kai ;
Zhou, Dexiang ;
Shu, Hang .
JOURNAL OF CLINICAL NEUROSCIENCE, 2014, 21 (01) :163-165
[5]   Remnants and Recurrences After the Use of the WEB Intrasaccular Device in Large-Neck Bifurcation Aneurysms [J].
Cognard, Christophe ;
Januel, Anne Christine .
NEUROSURGERY, 2015, 76 (05) :522-530
[6]   Results of Embolization Used as the First Treatment Choice in a Consecutive Nonselected Population of Ruptured Aneurysms: Clinical Results of the Clarity GDC Study [J].
Cognard, Christophe ;
Pierot, Laurent ;
Anxionnat, Rene ;
Ricolfi, Frederic .
NEUROSURGERY, 2011, 69 (04) :837-841
[7]   Review of 2 Decades of Aneurysm-Recurrence Literature, Part 1: Reducing Recurrence after Endovascular Coiling [J].
Crobeddu, E. ;
Lanzino, G. ;
Kallmes, D. F. ;
Cloft, H. J. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2013, 34 (02) :266-270
[8]  
Darflinger Robert J, 2015, J Vasc Interv Neurol, V8, P25
[9]   Infections related to coils used for embolization of arteries: Review of the published evidence [J].
Falagas, Matthew E. ;
Nikou, Sarantos A. ;
Siempos, Ilias I. .
JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY, 2007, 18 (06) :697-701
[10]   Partially Thrombosed Intracranial Aneurysms Presenting with Mass Effect: Long-Term Clinical and Imaging Follow-Up after Endovascular Treatment [J].
Ferns, S. P. ;
van Rooij, W. J. ;
Sluzewski, M. ;
van den Berg, R. ;
Majoie, C. B. L. M. .
AMERICAN JOURNAL OF NEURORADIOLOGY, 2010, 31 (07) :1197-1205