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. 2023 Mar 25;13(1):4904.
doi: 10.1038/s41598-023-31877-1.

Contour device implantation versus coil embolization for treatment of narrow neck intracranial aneurysms

Karim Mostafa #  1 , Fernando Bueno Neves #  2 , Friederike Gärtner  2 , Sönke Peters  2 , Johannes Hensler  2 , Naomi Larsen  2 , Tristan Klintz  2 , Justus Mahnke  2 , Olav Jansen  2 , Fritz Wodarg  2
Affiliations

Contour device implantation versus coil embolization for treatment of narrow neck intracranial aneurysms

Karim Mostafa et al. Sci Rep. .

Abstract

The novel Contour device is an intrasaccular flow disruption device designed for treatment of intracranial wide-neck bifurcation aneurysms. Outside its original purpose, Contour implantation can be used to treat aneurysms with a higher dome-to-neck ratio which would be suitable for conventional unassisted coil embolization. We compared both techniques in a retrospective single-center analysis. A total of 42 aneurysms from 42 patients with a dome-to-neck ratio of 1.6 or higher were included in this study. Data on technical success, implantation times, radiation dosages, procedural complications, reinterventions and recurrences were gathered and compared. Technical success was achieved in all cases with both techniques. Aneurysm embolization was achieved significantly faster in the Contour group compared to coiling (Overall p = 0.0002; r = 0.580; acute setting: p = 0.005, r = 0.531; elective setting: p = 0.002, r = 0.607). Significantly less radiation dosage was applied in the Contour group (Overall p = 0.002; r = 0.478; acute group p = 0.006; r = 0.552; elective group p = 0.045; r = 0.397). The number of complications was higher in the coiling group compared to the Contour group (Coiling 7/21 (33,3%); Contour 3/21 (14.3%). There was a higher rate of reinterventions in the coiling group (7.6% vs 21.4%). Outside its original intention, the Contour device seems to be a safe and fast alternative to coil embolization for the treatment of narrow-neck-aneurysms.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Schematic comparison of the Contour device in narrow- and wide-necked aneurysms. In both figures, the red circles depict aneurysms, with the inner circles representing the aneurysm neck and the outer circle the aneurysm dome. Image a represents (a) narrow-neck aneurysm and (b) a wide-neck aneurysm. Due to its geometry, there is a very high mesh density of the Contour device at the entry level of narrow-neck aneurysms, likely causing a favourably higher flow-disrupting effect (a) compared to wide-neck aneurysms (b).
Figure 2
Figure 2
Initial, postinterventional and follow-up angiograms of a patient after Contour implantation into an aneurysm basilar apex with a dome-to-neck ratio of 2.3. The patient presented with a basilar tip aneurysm (a). Immediately after Contour implantation residual aneurysm perfusion can be seen (b). After 6 months, the aneurysm is fully occluded on DSA images (c).
Figure 3
Figure 3
Angiograms of different outcomes in the O’Kelly Marotta grading scale immediately after Contour device implantation.
Figure 4
Figure 4
Angiograms of different outcomes in the Raymond Roy grading scale immediately after conventional aneurysm coiling.
See this image and copyright information in PMC

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