title: pCONus Device for the Endovascular Treatment of Wide-Neck Middle Cerebral Artery Aneurysms.
abstract: OBJECTIVE
  Endovascular treatment of bifurcation middle cerebral artery aneurysms with a wide neck could be challenging, and many lesions are still treated by a surgical approach. The pCONus is a newly emerging device for wide-neck bifurcation intracranial aneurysms. To date, a single report on the treatment of intracranial aneurysms including all locations has been published. We report our experience with pCONus in the treatment of wide-neck MCA aneurysms.
  
  
  METHODS
  MCA aneurysms treated with pCONus in 4 European centers were retrospectively reviewed.
  
  
  RESULTS
  Forty MCA aneurysms (mean dome size, 7.7 mm; mean neck size, 5.6 mm) were treated in 40 patients (mean age, 62 years). Aneurysm coiling was performed after deployment of 1 pCONus in 95% (38/40) of cases and after deployment of 2 pCONus devices in 5% (2/40). No procedural angiographic complications were observed. Reversible neurologic complications were noted in 5% (2/40), and permanent neurologic complication, in 2.5% (1/40) at 1 month. There was no mortality. No aneurysms bled or rebled after treatment. Immediate angiographic results were complete aneurysm occlusion in 25% (10/40), neck remnant in 47.5% (19/40), and aneurysm remnant in 27.5% (11/40). Follow-up (mean, 6.8 months) was available for 33 aneurysms (82.5%). Stable or improved results were observed in all except 3 cases, including 48.5% complete occlusions (16/33), 30.3% neck remnants (10/33), and 21.2% aneurysm remnants (7/33). There was no in-stent stenosis or jailed branch occlusion. There was no angiographic recurrence of initially totally occluded aneurysms.
  
  
  CONCLUSIONS
  MCA aneurysms with a wide neck are amenable to treatment with pCONus.
authors.affiliation: From the Department of Interventional Neuroradiology (B.G., F.T.), Neurologic Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
authors.forename: B
authors.identifier: http://orcid.org/0000-0001-8424-4464
authors.initials: B
authors.lastname: Gory
authors.affiliation: Department of Neuroradiology (M.A.-P., H.H.), Klinikum Stuttgart, Stuttgart, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Aguilar-Pérez
authors.affiliation: Department of Neuroradiology and Endovascular Therapy (E.P., A.B.), Jean-Minjoz Hospital, Franche-Comté University, Besançon, France.
authors.forename: E
authors.initials: E
authors.lastname: Pomero
authors.affiliation: From the Department of Interventional Neuroradiology (B.G., F.T.), Neurologic Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
authors.forename: F
authors.initials: F
authors.lastname: Turjman
authors.affiliation: Department of Neuroradiology (W.W., S.F.), Knappschaftskrankenhaus, Recklinghausen, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Weber
authors.affiliation: Department of Neuroradiology (W.W., S.F.), Knappschaftskrankenhaus, Recklinghausen, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Department of Neuroradiology (M.A.-P., H.H.), Klinikum Stuttgart, Stuttgart, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Henkes
authors.affiliation: Department of Neuroradiology and Endovascular Therapy (E.P., A.B.), Jean-Minjoz Hospital, Franche-Comté University, Besançon, France. biondi.alessandra@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Biondi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome