PulseRider-Assisted Coil Embolization for Treatment of Intracranial Bifurcation Aneurysms

A Single-Center Case Series with 24-Month Follow-up

Nobuyuki Sakai, Hirotoshi Imamura, Koichi Arimura, Takayuki Funatsu, Mikiya Beppu, K. Suzuki, Hiromasa Adachi, Tomohiro Okuda, Yuichi Matsui, Shuhei Kawabata, Ryo Akiyama, Kazufumi Horiuchi, Shoichi Tani, Hidemitsu Adachi, Chiaki Sakai, N. Kaneko, Satoshi Tateshima

Research output: Contribution to journalArticle

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Abstract

Background: Although endovascular coiling of unruptured aneurysms is widely accepted, the endovascular treatment of wide-neck bifurcation aneurysms remains one of the most challenging morphologies. Our purpose was to describe our experience with 24-month follow-up for the treatment of unruptured intracranial bifurcation aneurysms using the PulseRider (Cerenovus, New Brunswick, NJ). Methods: This study is a single-center, single-arm registry performed under institutional review board control to evaluate efficacy and safety of the PulseRider. Patients with bifurcation aneurysms were identified and enrolled prospectively. Angiography immediately after treatment and at 6 months, and magnetic resonance imaging and magnetic resonance angiography at 12- and 24-month follow-up were retrospectively analyzed. A modified Rankin score was obtained prior to procedure, at discharge, and at 6-, 12- and 24-month follow-up visits. Results: Eight patients with a mean age of 66 years were treated with the PulseRider. All patients had bifurcation aneurysms (2 anterior communicating, 2 carotid terminus, and 4 basilar apex). The aneurysm diameters ranged from 4.6 to 13.6 mm (mean 7.4 mm) with dome/neck ratio ranging from 1.4 to 2.2 (mean 1.6). In all cases, the PulseRider was successfully deployed. Complete occlusion was demonstrated at 6-month follow-up on 6 of 8 (75%), near complete occlusion in 1 of 8 (12.5%), and residual aneurysm in 1 of 8 (12.5%) patients. There was no change or recurrence on magnetic resonance angiography, nor clinical complication after the procedure through 24-month follow-up. Conclusions: Our experience with 24-month follow-up demonstrated favorable efficacy in the treatment of intracranial wide-neck bifurcation aneurysms using the PulseRider.

Original languageEnglish
Pages (from-to)e461-e467
JournalWorld Neurosurgery
Volume128
DOIs
Publication statusPublished - Aug 1 2019

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Intracranial Aneurysm
Aneurysm
Neck
Magnetic Resonance Angiography
Therapeutics
New Brunswick
Research Ethics Committees
Registries
Angiography
Magnetic Resonance Imaging
Safety
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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PulseRider-Assisted Coil Embolization for Treatment of Intracranial Bifurcation Aneurysms : A Single-Center Case Series with 24-Month Follow-up. / Sakai, Nobuyuki; Imamura, Hirotoshi; Arimura, Koichi; Funatsu, Takayuki; Beppu, Mikiya; Suzuki, K.; Adachi, Hiromasa; Okuda, Tomohiro; Matsui, Yuichi; Kawabata, Shuhei; Akiyama, Ryo; Horiuchi, Kazufumi; Tani, Shoichi; Adachi, Hidemitsu; Sakai, Chiaki; Kaneko, N.; Tateshima, Satoshi.

In: World Neurosurgery, Vol. 128, 01.08.2019, p. e461-e467.

Research output: Contribution to journalArticle

Sakai, N, Imamura, H, Arimura, K, Funatsu, T, Beppu, M, Suzuki, K, Adachi, H, Okuda, T, Matsui, Y, Kawabata, S, Akiyama, R, Horiuchi, K, Tani, S, Adachi, H, Sakai, C, Kaneko, N & Tateshima, S 2019, 'PulseRider-Assisted Coil Embolization for Treatment of Intracranial Bifurcation Aneurysms: A Single-Center Case Series with 24-Month Follow-up', World Neurosurgery, vol. 128, pp. e461-e467. https://doi.org/10.1016/j.wneu.2019.04.177
Sakai, Nobuyuki ; Imamura, Hirotoshi ; Arimura, Koichi ; Funatsu, Takayuki ; Beppu, Mikiya ; Suzuki, K. ; Adachi, Hiromasa ; Okuda, Tomohiro ; Matsui, Yuichi ; Kawabata, Shuhei ; Akiyama, Ryo ; Horiuchi, Kazufumi ; Tani, Shoichi ; Adachi, Hidemitsu ; Sakai, Chiaki ; Kaneko, N. ; Tateshima, Satoshi. / PulseRider-Assisted Coil Embolization for Treatment of Intracranial Bifurcation Aneurysms : A Single-Center Case Series with 24-Month Follow-up. In: World Neurosurgery. 2019 ; Vol. 128. pp. e461-e467.
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title = "PulseRider-Assisted Coil Embolization for Treatment of Intracranial Bifurcation Aneurysms: A Single-Center Case Series with 24-Month Follow-up",
abstract = "Background: Although endovascular coiling of unruptured aneurysms is widely accepted, the endovascular treatment of wide-neck bifurcation aneurysms remains one of the most challenging morphologies. Our purpose was to describe our experience with 24-month follow-up for the treatment of unruptured intracranial bifurcation aneurysms using the PulseRider (Cerenovus, New Brunswick, NJ). Methods: This study is a single-center, single-arm registry performed under institutional review board control to evaluate efficacy and safety of the PulseRider. Patients with bifurcation aneurysms were identified and enrolled prospectively. Angiography immediately after treatment and at 6 months, and magnetic resonance imaging and magnetic resonance angiography at 12- and 24-month follow-up were retrospectively analyzed. A modified Rankin score was obtained prior to procedure, at discharge, and at 6-, 12- and 24-month follow-up visits. Results: Eight patients with a mean age of 66 years were treated with the PulseRider. All patients had bifurcation aneurysms (2 anterior communicating, 2 carotid terminus, and 4 basilar apex). The aneurysm diameters ranged from 4.6 to 13.6 mm (mean 7.4 mm) with dome/neck ratio ranging from 1.4 to 2.2 (mean 1.6). In all cases, the PulseRider was successfully deployed. Complete occlusion was demonstrated at 6-month follow-up on 6 of 8 (75{\%}), near complete occlusion in 1 of 8 (12.5{\%}), and residual aneurysm in 1 of 8 (12.5{\%}) patients. There was no change or recurrence on magnetic resonance angiography, nor clinical complication after the procedure through 24-month follow-up. Conclusions: Our experience with 24-month follow-up demonstrated favorable efficacy in the treatment of intracranial wide-neck bifurcation aneurysms using the PulseRider.",
author = "Nobuyuki Sakai and Hirotoshi Imamura and Koichi Arimura and Takayuki Funatsu and Mikiya Beppu and K. Suzuki and Hiromasa Adachi and Tomohiro Okuda and Yuichi Matsui and Shuhei Kawabata and Ryo Akiyama and Kazufumi Horiuchi and Shoichi Tani and Hidemitsu Adachi and Chiaki Sakai and N. Kaneko and Satoshi Tateshima",
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T1 - PulseRider-Assisted Coil Embolization for Treatment of Intracranial Bifurcation Aneurysms

T2 - A Single-Center Case Series with 24-Month Follow-up

AU - Sakai, Nobuyuki

AU - Imamura, Hirotoshi

AU - Arimura, Koichi

AU - Funatsu, Takayuki

AU - Beppu, Mikiya

AU - Suzuki, K.

AU - Adachi, Hiromasa

AU - Okuda, Tomohiro

AU - Matsui, Yuichi

AU - Kawabata, Shuhei

AU - Akiyama, Ryo

AU - Horiuchi, Kazufumi

AU - Tani, Shoichi

AU - Adachi, Hidemitsu

AU - Sakai, Chiaki

AU - Kaneko, N.

AU - Tateshima, Satoshi

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Background: Although endovascular coiling of unruptured aneurysms is widely accepted, the endovascular treatment of wide-neck bifurcation aneurysms remains one of the most challenging morphologies. Our purpose was to describe our experience with 24-month follow-up for the treatment of unruptured intracranial bifurcation aneurysms using the PulseRider (Cerenovus, New Brunswick, NJ). Methods: This study is a single-center, single-arm registry performed under institutional review board control to evaluate efficacy and safety of the PulseRider. Patients with bifurcation aneurysms were identified and enrolled prospectively. Angiography immediately after treatment and at 6 months, and magnetic resonance imaging and magnetic resonance angiography at 12- and 24-month follow-up were retrospectively analyzed. A modified Rankin score was obtained prior to procedure, at discharge, and at 6-, 12- and 24-month follow-up visits. Results: Eight patients with a mean age of 66 years were treated with the PulseRider. All patients had bifurcation aneurysms (2 anterior communicating, 2 carotid terminus, and 4 basilar apex). The aneurysm diameters ranged from 4.6 to 13.6 mm (mean 7.4 mm) with dome/neck ratio ranging from 1.4 to 2.2 (mean 1.6). In all cases, the PulseRider was successfully deployed. Complete occlusion was demonstrated at 6-month follow-up on 6 of 8 (75%), near complete occlusion in 1 of 8 (12.5%), and residual aneurysm in 1 of 8 (12.5%) patients. There was no change or recurrence on magnetic resonance angiography, nor clinical complication after the procedure through 24-month follow-up. Conclusions: Our experience with 24-month follow-up demonstrated favorable efficacy in the treatment of intracranial wide-neck bifurcation aneurysms using the PulseRider.

AB - Background: Although endovascular coiling of unruptured aneurysms is widely accepted, the endovascular treatment of wide-neck bifurcation aneurysms remains one of the most challenging morphologies. Our purpose was to describe our experience with 24-month follow-up for the treatment of unruptured intracranial bifurcation aneurysms using the PulseRider (Cerenovus, New Brunswick, NJ). Methods: This study is a single-center, single-arm registry performed under institutional review board control to evaluate efficacy and safety of the PulseRider. Patients with bifurcation aneurysms were identified and enrolled prospectively. Angiography immediately after treatment and at 6 months, and magnetic resonance imaging and magnetic resonance angiography at 12- and 24-month follow-up were retrospectively analyzed. A modified Rankin score was obtained prior to procedure, at discharge, and at 6-, 12- and 24-month follow-up visits. Results: Eight patients with a mean age of 66 years were treated with the PulseRider. All patients had bifurcation aneurysms (2 anterior communicating, 2 carotid terminus, and 4 basilar apex). The aneurysm diameters ranged from 4.6 to 13.6 mm (mean 7.4 mm) with dome/neck ratio ranging from 1.4 to 2.2 (mean 1.6). In all cases, the PulseRider was successfully deployed. Complete occlusion was demonstrated at 6-month follow-up on 6 of 8 (75%), near complete occlusion in 1 of 8 (12.5%), and residual aneurysm in 1 of 8 (12.5%) patients. There was no change or recurrence on magnetic resonance angiography, nor clinical complication after the procedure through 24-month follow-up. Conclusions: Our experience with 24-month follow-up demonstrated favorable efficacy in the treatment of intracranial wide-neck bifurcation aneurysms using the PulseRider.

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