title: The pCONus Device for Treatment of Complex Wide-Neck Anterior Communicating Artery Aneurysms.
abstract: OBJECTIVE
  Anterior communicating artery (AcomA) aneurysms with a wide neck are often not feasible for endovascular coiling. Emerging devices for neck protection, such as the pCONus stent, are promising for endovascular treatment of challenging intracranial aneurysms. We report the preliminary results with pCONus in the treatment of wide-neck AcomA aneurysms.
  
  
  METHODS
  All consecutive patients harboring AcomA aneurysms treated with pCONus in 3 European centers were retrospectively reviewed.
  
  
  RESULTS
  Thirty-six patients (mean age, 61 years) harboring 36 saccular AcomA aneurysms (mean dome size, 7.3 mm; mean neck size, 5.4 mm) were included, of which 7 were treated in the setting of subarachnoid hemorrhage. A procedural angiographic complication was reported in 3 patients without clinical impact at 3 months. Five patients presented a postoperative neurological deficit without angiographic complication. Procedure-related permanent morbidity and mortality rates were 11% (3/33) and 0 at 3 months, respectively. Postoperative angiographic results showed a complete aneurysm occlusion in 56% (20/36), a neck remnant in 25% (9/36), and an aneurysm remnant in 19% (7/36) of cases. Four patients were retreated after early angiographic follow-up (mean, 3.2 months). Twenty-two patients were followed (mean, 12.9 months), and a complete aneurysm occlusion was observed in 59% of patients (13/22), and a neck remnant in 41% (9/22). There was no in-stent stenosis or jailed branch occlusion. Recanalization rate was 9%.
  
  
  CONCLUSIONS
  The pCONus device allows endovascular coiling of wide-necked AcomA aneurysms.
authors.affiliation: Department of Interventional Neuroradiology, Neurologic Hospital Pierre Wertheimer, Hospices Civil de Lyon, Lyon, France. Electronic address: Labeyriepaulemile@gmail.com.
authors.forename: Paul Emile
authors.initials: PE
authors.lastname: Labeyrie
authors.affiliation: Department of Interventional Neuroradiology, Neurologic Hospital Pierre Wertheimer, Hospices Civil de Lyon, Lyon, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Gory
authors.affiliation: Department of Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany.
authors.forename: Marta
authors.initials: M
authors.lastname: Aguilar-Perez
authors.affiliation: Department of Neuroradiology and Endovascular Therapy, Jean-Minjoz Hospital, Franche-Comté University, Besançon, France.
authors.forename: Elisa
authors.initials: E
authors.lastname: Pomero
authors.affiliation: Department of Neuroradiology and Endovascular Therapy, Jean-Minjoz Hospital, Franche-Comté University, Besançon, France.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Biondi
authors.affiliation: Department of Interventional Neuroradiology, Neurologic Hospital Pierre Wertheimer, Hospices Civil de Lyon, Lyon, France.
authors.forename: Roberto
authors.initials: R
authors.lastname: Riva
authors.affiliation: Department of Interventional Neuroradiology, Neurologic Hospital Pierre Wertheimer, Hospices Civil de Lyon, Lyon, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Turjman
authors.affiliation: Department of Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Henkes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: Anterior communicating artery; Device; Intracranial aneurysm; Subarachnoid hemorrhage