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Goertz L, Radomi A, Forbrig R, Pflaeging M, Kabbasch C, Liebig T. Endovascular treatment of aneurysm remnants with the Contour Neurovascular System after previous treatment. Interv Neuroradiol 2024:15910199241264871. [PMID: 39091055 DOI: 10.1177/15910199241264871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE The Contour Neurovascular System (CNS) is a novel intrasaccular flow disrupting device with a semi-3D cup-like shape for the treatment of intracranial aneurysms. This study investigates the potential and limitations of the CNS for embolization of aneurysm remnants after previous treatment. METHODS Ten cases of aneurysm recurrence treatment with the CNS were analyzed from a single-center database. Technical success, procedural aspects, complications, and angiographic results were evaluated. RESULTS The aneurysms (median width: 5.3 mm, median neck width: 3.8 mm) were located in the anterior communicating artery (4), basilar tip (3), internal carotid artery (1), middle cerebral artery (1), and superior cerebellar artery (1). The aneurysms were initially treated endovascularly (9) and by clipping (1). Retreatment failed in one case where the smallest available CNS proved to be too small and had to be removed. Adjunctive coiling was performed in two large remnants of partially thrombosed basilar tip aneurysms. There were no procedural complications or morbidity. At a median follow-up of nine months, 4/8 (50%) aneurysms were completely occluded, 2/8 (25%) had neck remnants, and 2/8 (25%) had aneurysm remnants. The two aneurysm remnants were retreated with coiling and stent-assisted coiling, respectively. CONCLUSIONS CNS treatment of aneurysm remnants may be feasible, especially for shallow, wide-necked aneurysm geometries. Further studies are needed to identify aneurysm subsets that benefit from CNS retreatment and to define mid- and long-term occlusion rates.
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Affiliation(s)
- Lukas Goertz
- Faculty of Medicine and University Hospital, Department of Radiology and Neuroradiology, University of Cologne, Cologne, Germany
| | - Alexandra Radomi
- Institute of Neuroradiology, University Hospital Munich (LMU), Munich, Germany
| | - Robert Forbrig
- Institute of Neuroradiology, University Hospital Munich (LMU), Munich, Germany
| | - Muriel Pflaeging
- Institute of Neuroradiology, University Hospital Munich (LMU), Munich, Germany
| | - Christoph Kabbasch
- Faculty of Medicine and University Hospital, Department of Radiology and Neuroradiology, University of Cologne, Cologne, Germany
| | - Thomas Liebig
- Institute of Neuroradiology, University Hospital Munich (LMU), Munich, Germany
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Korte J, Gaidzik F, Larsen N, Schütz E, Damm T, Wodarg F, Hövener JB, Jansen O, Janiga G, Berg P, Pravdivtseva MS. In vitro and in silico assessment of flow modulation after deploying the Contour Neurovascular System in intracranial aneurysm models. J Neurointerv Surg 2024; 16:815-823. [PMID: 37852752 PMCID: PMC11287554 DOI: 10.1136/jnis-2023-020403] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/15/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The novel Contour Neurovascular System (Contour) has been reported to be efficient and safe for the treatment of intracranial, wide-necked bifurcation aneurysms. Flow in the aneurysm and posterior cerebral arteries (PCAs) after Contour deployment has not been analyzed in detail yet. However, this information is crucial for predicting aneurysm treatment outcomes. METHODS Time-resolved three-dimensional velocity maps in 14 combinations of patient-based basilar tip aneurysm models with and without Contour devices (sizes between 5 and 14 mm) were analyzed using four-dimensionsal (4D) flow MRI and numerical/image-based flow simulations. A complex virtual processing pipeline was developed to mimic the experimental shape and position of the Contour together with the simulations. RESULTS On average, the Contour significantly reduced intra-aneurysmal flow velocity by 67% (mean w/ = 0.03m/s; mean w/o = 0.12m/s; p-value=0.002), and the time-averaged wall shear stress by more than 87% (mean w/ = 0.17Pa; mean w/o = 1.35Pa; p-value=0.002), as observed by numerical simulations. Furthermore, a significant reduction in flow (P<0.01) was confirmed by the neck inflow rate, kinetic energy, and inflow concentration index after Contour deployment. Notably, device size has a stronger effect on reducing flow than device positioning. However, positioning affected flow in the PCAs, while being robust in effectively reducing flow. CONCLUSIONS This study showed the high efficacy of the Contour device in reducing flow within aneurysms regardless of the exact position. However, we observed an effect on the flow in PCAs, which needs to be investigated further.
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Affiliation(s)
- Jana Korte
- Laboratory of Fluid Dynamics and Technical Flows, University of Magdeburg, Magdeburg, Germany
- Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany
| | - Franziska Gaidzik
- Laboratory of Fluid Dynamics and Technical Flows, University of Magdeburg, Magdeburg, Germany
- Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany
| | - Naomi Larsen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel, Germany
| | - Erik Schütz
- Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany
| | - Timo Damm
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Fritz Wodarg
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel, Germany
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
| | - Olav Jansen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel, Germany
| | - Gábor Janiga
- Laboratory of Fluid Dynamics and Technical Flows, University of Magdeburg, Magdeburg, Germany
- Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany
| | - Philipp Berg
- Research campus STIMULATE, University of Magdeburg, Magdeburg, Germany
- Department of Healthcare Telematics and Medical Engineering, University of Magdeburg, Magdeburg, Germany
| | - Mariya S Pravdivtseva
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein (UKSH), Kiel University, Kiel, Germany
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Spitz L, Korte J, Gaidzik F, Larsen N, Preim B, Saalfeld S. Assessment of intracranial aneurysm neck deformation after contour deployment. Int J Comput Assist Radiol Surg 2024:10.1007/s11548-024-03189-w. [PMID: 38819700 DOI: 10.1007/s11548-024-03189-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/14/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE The contour neurovascular system (CNS) is a novel device to treat intracranial wide-necked bifurcation aneurysms, with few studies assessing its long-term effects. Particularly its impact on aneurysm morphology has not been explored yet. We present a preliminary study to explore this impact for the first time, focusing on the neck curve and ostium of the aneurysm. METHODS We investigated seven aneurysms treated with the CNS to assess ostium deformation after CNS deployment by comparing models extracted from in vivo medical pre-treatment and follow-up scans via morphological analysis. Time between pre- and follow-up scans was ten months on average. Size and shape indices like area, neck diameter, ellipticity index, undulation index, and more were assessed. RESULTS Ostium size was reduced after treatment. On average, ostium area was reduced at a rate of - 0.58 (± 4.88) mm2 per year, from 15.52 (± 3.51) mm2 to 13.30 (± 2.27) mm2, and ostium width from 5.01 (± 0.54) mm to 4.49 (± 0.45) mm, with an average reduction of - 0.59 (± 0.87) mm. This shrinking positively correlated with time passing. Shape deformation was low, though notably mean ellipticity index was reduced by 0.06 (± 0.15) on average, indicating ostia were less elongated after treatment. CONCLUSION We interpret the shrinking of the ostium as part of the healing process. Shape changes were found to be small enough to conclude no shape deformation of the ostium from CNS deployment, but the analysis of more cases with more parameters and information is necessary.
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Affiliation(s)
- Lena Spitz
- Department of Simulation and Graphics, Otto-von-Guericke University, Universtitaetsplatz 2, 39106, Magdeburg, Sachsen-Anhalt, Germany.
- Research campus STIMULATE, Magdeburg, Germany.
| | - Jana Korte
- Research campus STIMULATE, Magdeburg, Germany
- Laboratory of Fluid Dynamics and Technical Flows, Otto-von-Guericke University, Magdeburg, Germany
| | - Franziska Gaidzik
- Research campus STIMULATE, Magdeburg, Germany
- Laboratory of Fluid Dynamics and Technical Flows, Otto-von-Guericke University, Magdeburg, Germany
| | - Naomi Larsen
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Bernhard Preim
- Department of Simulation and Graphics, Otto-von-Guericke University, Universtitaetsplatz 2, 39106, Magdeburg, Sachsen-Anhalt, Germany
- Research campus STIMULATE, Magdeburg, Germany
| | - Sylvia Saalfeld
- Research campus STIMULATE, Magdeburg, Germany
- Computational Medicine Group, Technical University Ilmenau, Ilmenau, Germany
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Griessenauer CJ, Ghozy S, Biondi A, Hecker C, Wodarg F, Liebig T, Patankar T, Lamin S, Martínez-Galdámez M, Cognard C, Fiehler J, Dorn F, Dmytriw AA, Killer-Oberpfalzer M. Contour Neurovascular System for endovascular embolization of cerebral aneurysms: a multicenter cohort study of 10 European neurovascular centers. J Neurointerv Surg 2024:jnis-2023-021378. [PMID: 38760167 DOI: 10.1136/jnis-2023-021378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 04/28/2024] [Indexed: 05/19/2024]
Abstract
BACKGROUND Intrasaccular devices have become increasingly popular in the treatment of cerebral aneurysms, particularly at the bifurcation. Here we evaluate the Contour Neurovascular System, an intrasaccular device for the endovascular treatment of cerebral aneurysms, in a multicenter cohort study, the largest to the best of our knowledge. METHODS Consecutive patients with intracranial aneurysms treated with the Contour Neurovascular System between February 2017 and October 2022 at 10 European neurovascular centers were prospectively collected and retrospectively reviewed. Patient and aneurysm characteristics, procedural details, and angiographic and clinical outcomes were evaluated. RESULTS During the study period, 279 aneurysms (median age of patients 60 years, IQR 52-68) were treated with Contour. In 83.2% of patients the device was placed electively, whereas the remaining patients were treated in the setting of acute subarachnoid hemorrhage. The most common locations were the middle cerebral artery (26.5%) followed by the anterior communicating region (26.2%). Median aneurysm dome and neck size were 5.2 mm (IQR 4.2-7) and 3.9 mm (IQR 3-5). Contour size 7 (39%) and 9 (25%) were most used. Thromboembolic and hemorrhagic complications occurred in 6.8% and 0.4% of aneurysms, respectively. Raymond-Roy 1 and 2 occlusions at last follow-up were achieved in 63.2% and 28.3%, respectively, resulting in adequate occlusion of 91.5% of aneurysms. CONCLUSION This is the largest multicenter study reporting the outcome on the Contour Neurovascular System. At 1 year, the self-evaluated data on safety and efficacy are comparable to data of existing intrasaccular devices. Contour is a promising technology in the treatment of cerebral aneurysms.
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Affiliation(s)
- Christoph J Griessenauer
- Department of Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria
| | - Sherief Ghozy
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Alessandra Biondi
- Department of Interventional Neuroradiology, Besançon University Hospital, Besançon, France
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR 481 LINC, Université Franche-Comté, Besançon, France
| | - Constantin Hecker
- Department of Neurosurgery, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria
- Institute of Neurointervention, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Fritz Wodarg
- Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Thomas Liebig
- Department of Neuroradiology, University Hospital Munich (LMU), Munich, Germany
| | - Tufail Patankar
- Department of Neuroradiology, Leeds General Infirmary, Leeds, UK
| | - Saleh Lamin
- Diagnostic and Interventional Neuroradiology, University Hospital Birmingham, Queen Elizabeth, Birmingham, UK
| | - Mario Martínez-Galdámez
- Interventional Neuroradiology/Endovascular Neurosurgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
- Department of Radiology and Interventional Neuroradiology, Hospital La Luz, Quironsalud, Madrid, Spain
| | | | - Jens Fiehler
- Department of Neuroradiology, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Franziska Dorn
- Department of Neuroradiology, University of Bonn, Bonn, Germany
| | - Adam A Dmytriw
- Neuroendovascular Program, Massachusetts General Hospital, Boston, Massachusetts, USA
- Neuroradiology & Neurointervention, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Monika Killer-Oberpfalzer
- Institute of Neurointervention, Paracelsus Medical University Salzburg, Salzburg, Austria
- Department of Neurology, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria
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Jagtiani P, Sioutas GS, Vivanco-Suarez J, Burkhardt JK, Srinivasan VM. An updated meta-analysis on the safety and effectiveness of the Contour Neurovascular system. Interv Neuroradiol 2024:15910199231226280. [PMID: 38225202 DOI: 10.1177/15910199231226280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Affiliation(s)
- Pemla Jagtiani
- School of Medicine, SUNY Downstate Health Sciences University, New York, NY, USA
| | - Georgios S Sioutas
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Juan Vivanco-Suarez
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Visish M Srinivasan
- Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Bellanger G, Darcourt J, Januel AC, Cognard C. The reversed umbrella: displacement of a Contour device into an MCA aneurysm 18 months after treatment. J Neurointerv Surg 2024; 16:213-215. [PMID: 36941045 DOI: 10.1136/jnis-2022-019814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 02/05/2023] [Indexed: 03/22/2023]
Abstract
SummaryThe Contour is a promising new device designed to treat large-neck intra-cranial aneurysms. We describe a first case of Contour device displacement 18 months after initial treatment.A patient with a 10 mm unruptured right middle cerebral artery bifurcation aneurysm was treated with a 9 mm Contour. The device was correctly positioned at the neck during treatment and at the 6 month angiography follow-up. At 18 months follow-up we noticed a full displacement of the device into the aneurysm dome. The Contour had a reversed shape and the aneurysm was still fully opacified. No neurological event occurred during the whole follow-up. Contour may be a promising tool but needs to be assessed over a long-term period.
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Affiliation(s)
| | - Jean Darcourt
- Diagnostic and Therapeutic Neuroradiology, Hôpital Purpan, Toulouse, France
| | | | - Christophe Cognard
- Diagnostic and Therapeutic Neuroradiology, Hôpital Purpan, Toulouse, France
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Biondi A, Primikiris P, Vitale G, Charbonnier G. Endosaccular flow disruption with the Contour Neurovascular System: angiographic and clinical results in a single-center study of 60 unruptured intracranial aneurysms. J Neurointerv Surg 2023; 15:838-843. [PMID: 35995545 DOI: 10.1136/jnis-2022-019271] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/06/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Contour Neurovascular System is a novel device designed to treat intracranial aneurysms by intrasaccular flow disruption. We report our experience and mid-term follow-up in a series of patients treated with the Contour. METHODS The patients were divided into an intention to treat and a per protocol population, the latter defined by the successful implantation of the Contour device. The intention to treat population included 53 patients (30 women, mean age 56 years) with 60 unruptured intracranial aneurysms (53 in the anterior circulation and seven in the posterior circulation). There was clinical and angiographic follow-up immediate postoperatively and at 24 hours, 3 months and 1 year using the Raymond-Roy classification and the O'Kelly-Marotta grading scale. RESULTS The Contour was successfully implanted in 54/60 (90%) aneurysms. With regard to the angiographic follow-up, there was adequate occlusion (defined as complete occlusion or presence of a neck remnant) in 31.5% of 54 aneurysms immediately postoperatively, 62.3% (in 53/54 aneurysms) at 24 hours, 81.4% (in 43/54 aneurysms) at 3 months, and 89.3% (in 28/54 aneurysms) at 1 year. Technical complications in 60 aneurysms of the intention to treat population included two (3.3%) inadvertent detachments of the device. Thromboembolic events were observed in four of the 60 aneurysms (6.7%), with no clinical symptoms in three patients and transient morbidity in one (1.7%). No aneurysm bleeding was observed and no patient was retreated during the 1-year follow-up period. There was no permanent morbidity or mortality. CONCLUSIONS The Contour device is effective and safe in the treatment of intracranial aneurysms. However, more experience and long-term follow-up are needed.
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Affiliation(s)
- Alessandra Biondi
- Department of Interventional Neuroradiology, University Hospital Centre Besancon, Besancon, France
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR 481, Université de Franche-Comté, Besancon, France
| | - Panagiotis Primikiris
- Department of Interventional Neuroradiology, University Hospital Centre Besancon, Besancon, France
| | - Giovanni Vitale
- Department of Interventional Neuroradiology, University Hospital Centre Besancon, Besancon, France
| | - Guillaume Charbonnier
- Department of Interventional Neuroradiology, University Hospital Centre Besancon, Besancon, France
- Laboratoire de Recherches Intégratives en Neurosciences et Psychologie Cognitive - UR 481, Université de Franche-Comté, Besancon, France
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Gallo-Pineda F, Fernández-Gómez M, Hidalgo-Barranco C. Rescue stenting after artery occlusion as a complication of an intrasaccular device-assisted coiling embolization: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 5:CASE23171. [PMID: 38015019 PMCID: PMC10550550 DOI: 10.3171/case23171] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/10/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Endovascular embolization of wide-necked aneurysms can be challenging. The development of intrasaccular devices like the Contour has enabled us to approach these aneurysms effectively by reducing recanalization rates and eliminating the need for dual antiplatelet therapy, which is particularly beneficial in the case of ruptured aneurysms. Although complications from using these devices are rare, it is crucial to address them properly. In this case, the authors highlight how to manage artery thrombosis caused by device protrusion during aneurysm embolization. OBSERVATIONS This report describes a complication in a male patient with a ruptured anterior communicating artery wide-necked aneurysm. Following Contour-assisted coiling of the aneurysm, a realignment of the detachable apex of the device occluded the A2 segment of the right anterior cerebral artery. After the failure of intra-arterial and intravenous tirofiban infusion as well as mechanical thrombectomy, a self-expanding open-cell stent was deployed in the involved vessel, achieving successful reperfusion. LESSONS The Contour device has a detachable zone that can cause occlusion of the parent vessel after deployment. The use of a stent as a rescue maneuver may be useful if reperfusion of the vessel cannot be achieved through other methods such as aspiration or full-dose antiplatelet therapy.
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Affiliation(s)
| | - Miriam Fernández-Gómez
- Division of Interventional Neuroradiology, Torrecárdenas University Hospital, Almería, Spain
| | - Carlos Hidalgo-Barranco
- Division of Interventional Neuroradiology, Torrecárdenas University Hospital, Almería, Spain
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Ghozy S, Lashin BI, Elfil M, Bilgin C, Kobeissi H, Shehata M, Kadirvel R, Kallmes DF. The safety and effectiveness of the Contour Neurovascular System for the treatment of wide-necked aneurysms: A systematic review and meta-analysis of early experience. Interv Neuroradiol 2022:15910199221139546. [PMID: 36384322 DOI: 10.1177/15910199221139546] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND The Contour is a new generation intrasaccular flow disruption tool that aims to cover the aneurysm neck and is sized according to the neck diameter. While several case series have been published, no literature review has been performed on this promising device. OBJECTIVE To assess the safety and effectiveness profile of the Contour Neurovascular System for wide-necked aneurysms. METHODS We followed the recommendations of the PRISMA checklist Four databases were searched with a supplemental manual search. All data were analyzed using R software version 4.2.1. RESULTS We finally included six studies with 131 treated aneurysms. The overall procedural time was 97.27 (95% CI = 70.07-124.47) minutes, ranging from 78.9 to 136.0 min. The pooled adequate occlusion rate was 84.21% (95% CI = 75.45-90.25), and the overall functional independence rate was 94.74% (87.97-97.79). The overall adverse event rate was 4.70 (95% CI = 3.24-6.76), varying among different events from 0.78 to 8.53%. Thromboembolic events were the most commonly encountered in 8.53% of the patients (95% CI = 4.78-14.74), followed by headache and minor stroke with incidence rates of 5.88 (95% CI = 2.83-11.83) and 4.35 (95% CI = 1.41-12.63), respectively. The overall procedural time in studies using the Contour system only was 86.17 (95% CI = 68.70-10.64) minutes, while it was 136 (95% CI = 90.96-181.04) in the Contour-assisted coiling procedures. However, both techniques were comparable regarding adequate occlusion rates and functional independence. CONCLUSION With the anticipation of future studies, the Contour Neurovascular System is a safe and effective treatment option for wide-necked intracranial aneurysms.
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Affiliation(s)
- Sherief Ghozy
- Department of Radiology, 6915Mayo Clinic, Rochester, MN, USA
- Nuffield Department of Primary Care Health Sciences and Department for Continuing Education (EBHC program), Oxford University, Oxford, UK
| | | | - Mohamed Elfil
- Department of Neurological Sciences, 12284University of Nebraska Medical Center, Omaha, NE, USA
| | - Cem Bilgin
- Department of Radiology, 6915Mayo Clinic, Rochester, MN, USA
| | - Hassan Kobeissi
- College of Medicine, Central Michigan University, Mount Pleasant, MI, USA
| | - Mostafa Shehata
- Department of Radiology, 6915Mayo Clinic, Rochester, MN, USA
| | - Ramanathan Kadirvel
- Department of Radiology, 6915Mayo Clinic, Rochester, MN, USA
- Department of Neurologic Surgery, 6915Mayo Clinic, Rochester, MN, USA
| | - David F Kallmes
- Department of Radiology, 6915Mayo Clinic, Rochester, MN, USA
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