Journal article
Treatment of Unruptured Small and Medium-Sized Wide Necked Aneurysms Using the 64-Wire Surpass Evolve: A Subanalysis From the SEASE International Registry
Journal of the American Heart Association, Vol.13(21), e036365
11/05/2024
DOI: 10.1161/JAHA.124.036365
PMCID: PMC11935660
PMID: 39450745
Appears in UI Libraries Support Open Access
Abstract
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.BACKGROUNDFlow 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.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).METHODS AND RESULTSThis 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).Patients with small/medium-sized IAs can be effectively treated using the Surpass Evolve, a new generation, 64-wire, cobalt-chromium flow diverter.CONCLUSIONSPatients with small/medium-sized IAs can be effectively treated using the Surpass Evolve, a new generation, 64-wire, cobalt-chromium flow diverter.
Details
- Title: Subtitle
- Treatment of Unruptured Small and Medium-Sized Wide Necked Aneurysms Using the 64-Wire Surpass Evolve: A Subanalysis From the SEASE International Registry
- Creators
- Mahmoud Dibas - University of IowaJuan Vivanco-Suarez - University of IowaDemetrius K Lopes - Advocate Health CareRicardo A Hanel - Baptist Medical Center JacksonvilleAaron Rodriguez-Calienes - Universidad Científica del SurGustavo M Cortez - Baptist Medical Center JacksonvilleJohanna T Fifi - Mount Sinai Health SystemAlex Devarajan - Mount Sinai Health SystemGabor Toth - Cleveland ClinicThomas E Patterson - Cleveland ClinicDavid Altschul - Montefiore Medical CenterVitor M Pereira - St. Michael's HospitalXiao Y E Liu - St. Michael's HospitalAjit S Puri - University of Massachusetts Chan Medical SchoolAnna L Kühn - University of Massachusetts Chan Medical SchoolWaldo R Guerrero - University of South FloridaPriyank Khandelwal - Robert Wood Johnson University HospitalIvo Bach - Robert Wood Johnson University HospitalPeter T Kan - The University of Texas Medical Branch at GalvestonGautam Edhayan - The University of Texas Medical Branch at GalvestonMario Martinez-Galdamez - Hospital Clínico Universitario de ValladolidCurtis Given - Central Baptist HospitalBradley A Gross - University of PittsburghSandra Narayanan - Pacific Heart InstituteMilagros Galecio-Castillo - University of IowaShahram Derakhshani - Queen's HospitalSantiago Ortega-Gutierrez - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of the American Heart Association, Vol.13(21), e036365
- DOI
- 10.1161/JAHA.124.036365
- PMID
- 39450745
- PMCID
- PMC11935660
- NLM abbreviation
- J Am Heart Assoc
- ISSN
- 2047-9980
- eISSN
- 2047-9980
- Publisher
- Wiley
- Grant note
- Stryker Neurovascular
Stryker Neurovascular funded this study through an investigator-initiated grant. The funding source was not involved in study design, monitoring, data collection, statistical analyses, interpretation of results, or article writing.
- Language
- English
- Electronic publication date
- 10/25/2024
- Date published
- 11/05/2024
- Academic Unit
- Neurology; Radiology; Iowa Neuroscience Institute; Neurosurgery
- Record Identifier
- 9984738166202771
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