Advances in intrasaccular flow disruption in the treatment of intracranial aneurysm

doi:10.11817/j.issn.1673-9248.2022.06.012

Abstract

Abstract:

Intrasaccular flow disruption is an innovative method of treating intracranial wide-necked bifurcation aneurysms. It has raised widespread concern because it does not need dual antiplatelet therapy. At present, four different types of intrasaccular flow disruptions have been used to treat intracranial aneurysms. Previous studies have preliminarily shown the safety and efficacy of intrasaccular flow disruption. With the rapid development of equipment and technology, various intrasaccular flow disruptions have been optimized, and the indications have been gradually expanded accordingly. Further research has proved the safety and efficacy of these latest devices. The review aims to provide an overview of these devices and summarize the literature on the safety and efficacy of these devices in recent years.

Key words: Intrasaccular flow disruption, Aneurysm, Wide-necked, Bifurcation, Interventional therapy

Shijun Bi, Pengyu Pan, Tingzhun Zhu, Haifeng Zhang, Yushu Dong, Xu Gao, Guobiao Liang. Advances in intrasaccular flow disruption in the treatment of intracranial aneurysm[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(06): 443-446.

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https://zhnxgbzz.cma-cmc.com.cn/EN/Y2022/V16/I06/443

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References 30

1	Chen C, Dabhi N, Snyder MH, et al. Intrasaccular flow disruption for brain aneurysms: a systematic review of long-term outcomes [J]. J Neurosurg, 2021: 1-13. Online ahead of print.
2	Gawlitza M, Soize S, Manceau P, et al. An update on intrasaccular flow disruption for the treatment of intracranial aneurysms [J]. Expert Rev Med Devic, 2019, 16(3): 229-236.
3	王奎重, 刘卫东. 颅内动脉瘤瘤内扰流装置Woven EndoBridge的临床应用进展 [J]. 中国脑血管病杂志, 2021, 18(4): 277-282.
4	König I, Maurer C, Berlis A, et al. Treatment of ruptured and unruptured intracranial aneurysms with WEB 17 versus WEB 21 systems [J]. Clin Neuroradiol, 2021, 31(3): 691-697.
5	Dmytriw AA, Diestro JDB, Dibas M, et al. International study of intracranial aneurysm treatment using Woven EndoBridge: RESULts of the WorldWideWEB consortium [J]. Stroke, 2022, 53(2): A121037609.
6	Adeeb N, Dibas M, Diestro JDB, et al. Multicenter study for the treatment of sidewall versus bifurcation intracranial aneurysms with use of Woven EndoBridge (WEB) [J]. Radiology, 2022, 304(2): 372-382.
7	Essibayi MA, Lanzino G, Brinjikji W. Safety and efficacy of the Woven EndoBridge device for treatment of ruptured intracranial aneurysms: a systematic review and meta-analysis [J]. Am J NeuroradioL, 2021, 42(9): 1627-1632.
8	Girot JB, Caroff J, Cortese J, et al. Endovascular treatment of small and very small intracranial aneurysms with the Woven EndoBridge device [J]. Am J Neuroradiol, 2021, 42(7): 1276-1281.
9	Algin O, Corabay S, Ayberk G. Long-term efficacy and safety of WovenEndoBridge (WEB)-assisted cerebral aneurysm embolization [J]. Interv Neuroradiol, 2022: 15910199211060970.
10	Peterson C, Cord BJ. Recurrent and residual aneurysms after Woven EndoBridge (WEB) therapy: what's next? [J]. Cureus, 2021, 13(4): e14404.
11	Goertz L, Liebig T, Siebert E, et al. Woven EndoBridge embolization versus microsurgical clipping for unruptured anterior circulation aneurysms [J]. Neurosurgery, 2021, 88(4): 779-784.
12	Kabbasch C, Goertz L, Siebert E, et al. WEB embolization versus stent-assisted coiling: comparison of complication rates and angiographic outcomes [J]. J Neurointerv Surg, 2019, 11(8): 812-816.
13	Goertz L, Liebig T, Siebert E, et al. Intrasaccular flow disruption with the Woven EndoBridge for narrow-necked aneurysms: a safety and feasibility study [J]. World Neurosurg, 2021, 151: e278-e285.
14	Goertz L, Liebig T, Siebert E, et al. Stent-assisted WEB embolization: aneurysm characteristics, outcome and case report of a WEB delivered through a stent [J]. Acta Neurochir (Wien), 2022, 164(8): 2181-2190.
15	Al Saiegh F, Velagapudi L, Khanna O, et al. Predictors of aneurysm occlusion following treatment with the WEB device: systematic review and case series [J]. Neurosurg Rev, 2022, 45(2): 925-936.
16	Cortese J, Caroff J, Chalumeau V, et al. Determinants of cerebral aneurysm occlusion after embolization with the WEB device: a single-institution series of 215 cases with angiographic follow-up [J]. J Neurointerv Surg, 2022: neurintsurg-2022-018780.
17	Di Caterino F, Primikiris P, Vitale G, et al. Woven EndoBridge device immediate post-detachment tilt with later displacement: case report, rescue techniques, and review of the literature [J]. Interv Neuroradiol, 2020, 26(4): 483-487.
18	Abdelrady M, Dargazanli C, Derraz I, et al. Successful WEBectomy during embolization of temporal arteriovenous malformation-associated flow-related basilar aneurysms [J]. Interv Neuroradiol, 2021: 15910199211057693. Online ahead of print.
19	Ansari S, Zevallos CB, Farooqui M, et al. Optimal Woven EndoBridge (WEB) device size selection using automated volumetric software [J]. Brain Sciences, 2021, 11(7): 901.
20	Caroff J, Cortese J, Girot J, et al. Woven EndoBridge device shape modification can be mitigated with an appropriate oversizing strategy: a VasoCT based study [J]. J Neurointerv Surg, 2022, 14(1): neurintsurg-2020-017232.
21	Piotin M, Biondi A, Sourour N, et al. The LUNA aneurysm embolization system for intracranial aneurysm treatment: short-term, mid-term and long-term clinical and angiographic results [J]. J Neurointerv Surg, 2018, 10(12): e34.
22	Piotin M, Fahed R, Redjem H, et al. The ARTISSE intrasaccular device for intracranial aneurysm treatment: short-term, mid-term and long-term clinical and angiographic results [J]. J Neurointerv Surg, 2021: neurintsurg-2021-017806. Online ahead of print.
23	Aguilar Perez M, Bhogal P, Martinez Moreno R, et al. The Medina Embolic Device: early clinical experience from a single center [J]. J Neurointerv Surg, 2016, 9(1): 77-87.
24	Bhogal P, Brouwer PA, Yeo L, et al. The medina embolic device: karolinska experience [J]. Interv Neuroradiol, 2018, 24(1): 4-13.
25	Turk AS, Maia O, Ferreira CC, et al. Periprocedural safety of aneurysm embolization with the Medina Coil System: the early human experience [J]. J Neurointerv Surg, 2016, 8(2): 168-172.
26	Frölich AM, Nawka MT, Ernst M, et al. Intra-aneurysmal flow disruption after implantation of the Medina^® Embolization Device depends on aneurysm neck coverage [J]. PloS One, 2018, 13(2): e191975.
27	Haffaf I, Clarençon F, Shotar E, et al. Medina embolization device for the treatment of intracranial aneurysms: 18 months' angiographic results [J]. J Neurointerv Surg, 2019, 11(5): 516-522.
28	Liebig T, Killer-Oberpfalzer M, Gal G, et al. The safety and effectiveness of the Contour neurovascular system (Contour) for the treatment of Bifurcation aneurysms: the CERUS study [J]. Neurosurgery, 2022, 90(3): 270-277.
29	Akhunbay-Fudge CY, Deniz K, Tyagi AK, et al. Endovascular treatment of wide-necked intracranial aneurysms using the novel Contour Neurovascular System: a single-center safety and feasibility study [J]. J Neurointerv Surg, 2020, 12(10): 987-992.
30	Thormann M, Mpotsaris A, Behme D. Treatment of a middle cerebral artery bifurcation aneurysm with the novel Contour Neurovascular System compatible with 0.021″ catheters [J]. Neuroradiol J, 2022, 35(3): 396-398.

装置	结构	尺寸（mm）	输送导管直径（英寸）	释放方式	优点	缺点
WEB	72~216根镍钛合金丝（可含铂芯）；圆柱形和球形	直径3~11 高度2.0~9.6	0.033/0.027/ 0.021/0.017	电解分离、可回收	两端显影标记、多种直径网丝编织、DFT技术	压缩、移位现象
LUNA	72根镍钛合金丝和铂芯（双层）；卵圆形	直径4.5~8.5	0.021	电解分离、可回收	不受动脉瘤径颈比限制、适用于侧壁和小分叉部动脉瘤、DFT技术	临床研究较少
MED	花瓣形状镍钛合金；不透射线定形芯线；3D线圈	长度5~10	0.021	机械分离、可回收	释放方式同可解脱弹簧圈、框架型和填充型	单独使用效果欠佳
CNS	72根镍钛合金丝和铂芯（双层）；杯状	直径5~14	0.027/0.021	电解分离、可回收	可锚定在动脉瘤颈部、不受动脉瘤高度限制、DFT技术	移位现象

装置	结构	尺寸（mm）	输送导管直径（英寸）	释放方式	优点	缺点
WEB	72~216根镍钛合金丝（可含铂芯）；圆柱形和球形	直径3~11 高度2.0~9.6	0.033/0.027/ 0.021/0.017	电解分离、可回收	两端显影标记、多种直径网丝编织、DFT技术	压缩、移位现象
LUNA	72根镍钛合金丝和铂芯（双层）；卵圆形	直径4.5~8.5	0.021	电解分离、可回收	不受动脉瘤径颈比限制、适用于侧壁和小分叉部动脉瘤、DFT技术	临床研究较少
MED	花瓣形状镍钛合金；不透射线定形芯线；3D线圈	长度5~10	0.021	机械分离、可回收	释放方式同可解脱弹簧圈、框架型和填充型	单独使用效果欠佳
CNS	72根镍钛合金丝和铂芯（双层）；杯状	直径5~14	0.027/0.021	电解分离、可回收	可锚定在动脉瘤颈部、不受动脉瘤高度限制、DFT技术	移位现象

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