Evaluating Efficacy and Complications of Contour Intrasaccular Device in Cerebral Aneurysm Management: A Multicenter Analysis.

BACKGROUND: Intrasaccular devices provide a method for treating complex aneurysms without leaving metallic materials in the parent artery. Compared to other well-studied devices in neurointervention, the Contour device is relatively new as an intrasaccular flow diverter. This study examines its use in cases of incidental aneurysms and its application in the acute treatment of ruptured aneurysms. Additionally, it covers potential complications that may arise and methods for prevention. METHODS: We conducted a retrospective analysis of 25 patients who underwent treatment with the Contour device at 3 hospital centers. We collected data related to age, gender, baseline modified Rankin Scale, personal habits, medical history, procedure details, and angiographic results according to the Woven endobridge occlusion scale. RESULTS: A total of 15 patients (65.5%) achieved a satisfactory angiographic result (grade 0-0') 1 year after embolization. Contrast stagnation was observed in 14 patients (58.3%). Intraprocedural complications, such as device displacement, were documented in 3 patients (12%), while 2 patients (8%) had aggregates attached to the device. Regarding late complications, 5 patients (20%) experienced device displacement and 1 patient had a minor stroke (4%). Retreatment was necessary for 3 patients (12%), involving a flow diverter, stenting, and coiling. CONCLUSIONS: In summary, the Contour device offers a viable option for treating complex aneurysms. While initial results are promising, it is crucial to acknowledge a learning curve to minimize complications and achieve satisfactory angiographic results without the need for additional treatments.

RapidpulseTM cyclic aspiration system for acute ischemic stroke due to large vessel occlusions.

BACKGROUND: The best strategy to achieve optimal reperfusion outcomes during mechanical thrombectomy remains to be defined. The RapidPulseTM Cyclic Aspiration System is a novel technology, delivering high-frequency pulsed vacuum forces to increase the efficiency of aspiration thrombectomy. METHODS: Prospective, multicenter, open-label, core lab-adjudicated, two-arm study comparing safety and efficacy of a feasibility version of the RapidPulseTM system compared with contemporary controls. Primary endpoint was the rate of mTICI ≥ 2c after first-pass effect (FPE). Additional efficacy endpoints were the rates of mTICI ≥ 2b after first pass (modified FPE (mFPE)), last pass with study device defined as frontline technical success, and after all passes including rescue therapy. The primary safety endpoints included symptomatic ICH (sICH) within 24 h post-procedure. RESULTS: Between February 2022 to December 2022, 80 subjects were consented and enrolled in the study (n = 40 treatment arm, n = 40 control arm). In the intent to treat (ITT) population, mean age was 67.8 ± 11.5 years; 19 (47.5%) were male. Median NIHSS score was 16 (IQR: 13-22). Median ASPECTS score was 9 (IQR: 8-10). The rate of mTICI ≥ 2c after first pass was 53.9% in ITT population (60.0% in per-protocol population) versus 38.5% in the corresponding control population. Functional independence (mRS 0-2) at 90 days was achieved in 61.1% (22/36) in the RapidPulseTM arm and 52.8% (19/36) in the control arm. In the RapidPulseTM arm, no sICH within 24 h and no device-related morbidity or mortality occurred. CONCLUSION: Preliminary data suggests RapidPulseTM Aspiration System is highly effective and safe for recanalization of large vessel occlusions.