Background and Purpose

The principle of flow diversion has revolutionized the treatment of brain aneurysms. In this study, we report our experience of the new Surpass Evolve (SE) flow diverter in the treatment of intracranial aneurysms.

Material and Methods

Patients were treated with the SE as first-line therapy between May 2019 and June 2020 at 2 experienced institutions. Inclusion criteria were wide-necked, blister-like, or fusiform/dissecting aneurysms in the anterior and posterior circulation. Primary endpoint was technical success defined as favorable navigation to the target vessel and successful deployment of the SE. Secondary endpoints were favorable aneurysm occlusion defined as O’Kelly Marotta (OKM) scale C1-3 + D on follow-up, procedure-related complications and retreatment.

Results

A total of 46 aneurysms in 42 patients were treated with 57 SE flow diverters. Median aneurysm size was 6.6 mm (IQR 4.0–12.2 mm) with a median neck width of 4 mm (IQR 2.2–5.4 mm). On admission, 6 (13%) aneurysms were ruptured and 41 (89%) were located in the anterior circulation. The primary endpoint was reached in 96%. Median follow-up was 116 days (IQR 92–134 days) and available for 36/46 (78%) aneurysms. Favorable aneurysm occlusion was seen in 31/36 (86%) aneurysms and 27/36 (75%) were occluded completely. Parent artery occlusion appeared in 3 (3%) patients on follow-up and 2 aneurysms (6%) required additional treatment due to insufficient closure.

Conclusion

The new SE flow diverter is safe and seems to be effective with promising occlusion rates at short-term follow-up.

中文翻译：

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Surpass Evolve 分流器治疗颅内动脉瘤的初步经验

背景和目的

分流原理彻底改变了脑动脉瘤的治疗。在这项研究中，我们报告了我们使用新型 Surpass Evolve (SE) 分流器治疗颅内动脉瘤的经验。

材料与方法

2019 年 5 月至 2020 年 6 月期间，患者在 2 家经验丰富的机构接受 SE 作为一线治疗。入选标准是前循环和后循环中的宽颈、水疱样或梭形/夹层动脉瘤。主要终点是技术成功，定义为对目标船只的有利导航和 SE 的成功部署。次要终点是有利的动脉瘤闭塞，定义为随访中的 O'Kelly Marotta (OKM) 量表 C1-3 + D、手术相关并发症和再治疗。

结果

使用 57 个 SE 分流器治疗了 42 名患者中的 46 个动脉瘤。中位动脉瘤大小为 6.6 毫米（IQR 4.0-12.2 毫米），颈部宽度中值为 4 毫米（IQR 2.2-5.4 毫米）。入院时，6 个（13%）动脉瘤破裂，41 个（89%）位于前循环。主要终点达到 96%。中位随访时间为 116 天（IQR 92-134 天），可用于 36/46 (78%) 动脉瘤。在 31/36 (86%) 的动脉瘤和 27/36 (75%) 的动脉瘤中观察到良好的动脉瘤闭塞。随访中 3 名 (3%) 患者出现载瘤动脉闭塞，2 名动脉瘤 (6%) 由于闭合不充分而需要额外治疗。

结论

新的 SE 分流器是安全的，并且似乎在短期随访中具有良好的闭塞率是有效的。