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Observational Study
. 2024 Nov 5;13(21):e036365.
doi: 10.1161/JAHA.124.036365. Epub 2024 Oct 25.

Treatment of Unruptured Small and Medium-Sized Wide Necked Aneurysms Using the 64-Wire Surpass Evolve: A Subanalysis From the SEASE International Registry

Mahmoud Dibas  1 , Juan Vivanco-Suarez  1 , Demetrius K Lopes  2 , Ricardo A Hanel  3 , Aaron Rodriguez-Calienes  4 , Gustavo M Cortez  3 , Johanna T Fifi  5 , Alex Devarajan  5 , Gabor Toth  6 , Thomas E Patterson  6 , David Altschul  7 , Vitor M Pereira  8 , Xiao Y E Liu  8 , Ajit S Puri  9 , Anna L Kühn  9 , Waldo R Guerrero  10 , Priyank Khandelwal  11 , Ivo Bach  11 , Peter T Kan  12 , Gautam Edhayan  12 , Mario Martinez-Galdamez  13 , Curtis Given  14 , Bradley A Gross  15 , Sandra Narayanan  16 , Milagros Galecio-Castillo  1 , Shahram Derakhshani  17 , Santiago Ortega-Gutierrez  18
Affiliations
Observational Study

Treatment of Unruptured Small and Medium-Sized Wide Necked Aneurysms Using the 64-Wire Surpass Evolve: A Subanalysis From the SEASE International Registry

Mahmoud Dibas et al. J Am Heart Assoc. .

Abstract

Background: Flow diversion has revolutionized the management of wide-necked intracranial aneurysms (IAs). We aimed to assess the effectiveness and safety of the new generation 64-wire Surpass Evolve for the treatment of unruptured small/medium-sized IAs.

Methods and results: This is a subanalysis from the SEASE (Safety and Effectiveness Assessment of the Surpass Evolve) registry, an observational cohort study including 15 academic institutions in North America and Europe between July 2020 and October 2022. Patients with wide-necked saccular IAs, measuring <12 mm along the internal carotid artery and vertebrobasilar system, and treated with the Surpass Evolve were included. Primary effectiveness was complete occlusion (Raymond-Roy class 1) at follow-up (core laboratory adjudicated), and primary safety was major stroke (ischemic/hemorrhagic) in the territory supplied by the target artery or death. A total of 129 cases with 135 IAs were included (median age 59 years, 85.3% women). Median maximum IAs size and neck size were 5.1 and 3.9 mm, respectively. Most IAs were in the internal carotid artery C6 (65.9%, 89/135) and C7 (14.1%, 19/135) segments. At a median follow-up time of 10.2 months (interquartile range, 6.4-12.8), complete occlusion was 77.1% (101/131), ≥50% in-stent stenosis was 8.8% (11/125), and retreatment was 0.8% (1/125). Major stroke and mortality were reported in 2 (1.6%) patients and 1 (0.8%) patient, respectively. Size was the only factor associated with higher odds of incomplete occlusion (adjusted odds ratio, 1.2 [95% CI, 1.02-1.5]; P=0.03).

Conclusions: Patients with small/medium-sized IAs can be effectively treated using the Surpass Evolve, a new generation, 64-wire, cobalt-chromium flow diverter.

Keywords: Surpass Evolve; flow diversion; intracranial aneurysm; medium; small.

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Figures

Figure 1
Figure 1. Flowchart for the patients and aneurysms included in this study.
ICA indicates internal carotid artery; and SEASE, Safety and Effectiveness Assessment of the Surpass Evolve.
Figure 2
Figure 2. RR occlusion scale.
RR indicates Raymond‐Roy.
See this image and copyright information in PMC

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