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Multicenter Study
. 2025 Jul 31;97(4):963-970.
doi: 10.1227/neu.0000000000003666.

Novel Delivery System Significantly Improves Technical Success and Safety of the Endovascular Clip System (eCLIPs) While Maintaining Efficacy for the Treatment of Wide-Necked Bifurcation Aneurysms: A Prospective, Multisite Registry

Adam A Dmytriw  1   2 , Waleed Butt  3 , Raphaël Blanc  4 , Michel Piotin  4 , Joost DeVries  5 , Olivier Levrier  6 , Chrysanthi Papagiannaki  7 , Jan-Hendrik Buhk  8 , Ronni Mikkelsen  9 , Amira Al Raaisi  4 , Hocine Redjem  10 , Pierre Guedin  10 , Genevieve Milot  11 , Yves Chau  12 , Michael Chow  13 , Jose Maria Navasa  14 , Olivier Naggara  15 , Jacques Sedat  12 , Hubert-Armand Desal  16 , Sebastien Gazzola  17 , Bernd Turowski  18 , Emmanuel Chabert  19 , Jildaz Caroff  20 , Charbel Mounayer  21 , Hin Yue Lau  1 , Jeremy Rempel  13 , Cian O'Kelly  13 , Leif Sorensen  9
Affiliations
Multicenter Study

Novel Delivery System Significantly Improves Technical Success and Safety of the Endovascular Clip System (eCLIPs) While Maintaining Efficacy for the Treatment of Wide-Necked Bifurcation Aneurysms: A Prospective, Multisite Registry

Adam A Dmytriw et al. Neurosurgery. .

Abstract

Background and objectives: The endovascular clip systems (eCLIPs) implant bridges the neck of wide neck bifurcation aneurysms. This study presents safety and efficacy of eCLIPs cases of the first generation, eCLIPs bifurcation remodeling system (eBRS), and the current generation, eCLIPs electrolytic bifurcation system (eB).

Methods: A prospective registry collected: patient age, sex, aneurysm details, safety end points, and occlusion scores. All patients were reported for safety events. A subset of 74% with eBRS implants and 99% with eB implants formed a group for efficacy.

Results: The mean age was 57 years, and 70% were female. The Registry describes 280 patients: 101 in eBRS group and 179 in eB, with aneurysms at bifurcation locations. Implantation success was 81% and 92% for eBRS and eB, respectively ( P = .007). The follow-up period averaged 38 months for eBRS and 12 months for eB cases. The all-cause death rate was 3.2% (7% for eBRS and 1.1% for eB, P = .007), and neurological death rate was 2.3% (5% for eBRS and 0.5% for eB, P = .014). The rate of stroke was 1.8%, 2.0% for eBRS and 1.7% for eB ( P = NS). Rate of repeat procedure was 4.6% (8.9% for eBRS and 2.2% for eB, P = .01). For 57 eBRS patients at average 38 months postprocedure, 77% had modified Raymond-Roy Occlusion Classification (mRROC) scores of 1, 19% had mRROC 2, and satisfactory result (1 + 2) of 96%. For 144 eB patients at average 12 months postprocedure, 81% had mRROC 1, 15% mRROC 2, and satisfactory result (1 + 2) of 96%.

Conclusion: The eCLIPs implant provides durable aneurysm occlusion with a favorable safety profile. The current eB delivery system resulted in improved procedural and safety results over the archived eBRS. The eCLIPs platform offers an alternative treatment strategy for wide neck bifurcation aneurysms.

Keywords: Aneurysm; Coiling; Flow diversion; Intracerebral; Intrasaccular; Stent.

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References

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