title: One-year Angiographic Results After pCONus Stent-Assisted Coiling of 40 Wide-Neck Middle Cerebral Artery Aneurysms.
abstract: BACKGROUND
  Bifurcation middle cerebral artery (MCA) aneurysms with wide neck are amenable to endovascular coiling with pCONus stent, a recent device dedicated to wide-neck bifurcation intracranial aneurysms.
  
  
  OBJECTIVE
  To evaluate the 1-year angiographic follow-up of wide-neck MCA aneurysms treated with pCONus.
  
  
  METHODS
  Forty MCA aneurysms (mean dome size, 7.7 mm; mean neck size, 5.6 mm) coiled with pCONus were retrospectively evaluated. "Recanalization" was defined as worsening, and "progressive thrombosis" was defined as improvement on the Raymond scale.
  
  
  RESULTS
  Angiographic midterm (mean, 11.9 months; range, 3-20) follow-up was obtained in all aneurysms. Retreatment was performed in 9 aneurysms (22.5%) without clinical complications, and postoperative angiographic outcome included 2 complete occlusions and 7 neck remnants. Six aneurysms were followed after retreatment (mean, 8.8 months), and presented complete occlusion in 1 case, neck remnant in 4 cases, and aneurysm remnant in 1 case. Among the 31 aneurysms, follow-up showed complete occlusion in 67.7% (21/31), neck remnants in 29% (9/31), and aneurysm remnants in 3.3% (1/31). Adequate aneurysm occlusion (total occlusion and neck remnant) was obtained in 96.7% (30/31). Among these 31 aneurysms, improvement of the rate of occlusion was observed in 15 aneurysms (48.4%), and recurrence in 2 aneurysms (6.5%). There was no 1-year angiographic recurrence of 3- or 6-month totally occluded aneurysms.
  
  
  CONCLUSIONS
  pCONus stent allows a safe coiling of wide-neck MCA aneurysms usually considered as surgical with a low recanalization rate for those adequately occluded at 3 to 6 months. Angiographic results improve over time due to progressive aneurysm thrombosis in around 50% of cases.
authors.affiliation: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils 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-Pérez
authors.affiliation: Depart-ment of Neuroradiology and Vascular Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Elisa
authors.initials: E
authors.lastname: Pomero
authors.affiliation: FHU IRIS, Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
authors.forename: Francis
authors.initials: F
authors.lastname: Turjman
authors.affiliation: Department of Neuroradiology, Knappschaftskranken-haus, Recklinghausen, Germany.
authors.forename: Werner
authors.initials: W
authors.lastname: Weber
authors.affiliation: Department of Neuroradiology, Knappschaftskranken-haus, Recklinghausen, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Fischer
authors.affiliation: Department of Neuroradiology, Klinikum Stuttgart, Stuttgart, Germany.
authors.forename: Hans
authors.initials: H
authors.lastname: Henkes
authors.affiliation: Depart-ment of Neuroradiology and Vascular Unit, University Hospital Jean-Minjoz, Besançon, France.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Biondi
mesh_terms: D002533:Cerebral Angiography; D057510:Endovascular Procedures / Q000295:instrumentation*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
keywords: Clipping; Coiling; Intracranial aneurysm; Middle cerebral artery; Outcome; Stent-assisted coiling; Stenting