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Use of Cobalt–Chromium 64 Wires Surpass Evolve for the Treatment of Remnant Intracranial Aneurysms: A Subanalysis From the SEASE International Registry
Journal article   Open access   Peer reviewed

Use of Cobalt–Chromium 64 Wires Surpass Evolve for the Treatment of Remnant Intracranial Aneurysms: A Subanalysis From the SEASE International Registry

Mahmoud Dibas, Juan Vivanco-Suarez, Demetrius Klee Lopes, Ricardo A. Hanel, Aaron Rodriguez-Calienes, Gustavo M. Cortez, Johanna T. Fifi, Alex Devarajan, Gabor Toth, Thomas E. Patterson, …
Stroke: vascular and interventional neurology, Vol.5(2), e001470
03/2025
DOI: 10.1161/SVIN.124.001470
PMCID: PMC12671630
PMID: 41573176
url
https://doi.org/10.1161/SVIN.124.001470View
Published (Version of record) Open Access

Abstract

BACKGROUND The use of the Surpass Evolve flow diverter for intracranial aneurysms (IAs) has shown promising results, but there are no studies that evaluated its effectiveness for remnant previously treated IAs. This study aimed to evaluate the safety and effectiveness of Surpass Evolve for previously treated IAs. METHODS This subanalysis is derived from the SEASE (Safety and Effectiveness Assessment of Surpass Evolve) registry, a retrospective, multicentric, international cohort conducted across 15 academic institutions in North America and Europe between July 2020 and October 2022. Adult patients undergoing Surpass Evolve implantation for single saccular IAs were grouped into those with previously treated IAs by coiling or intrasaccular‐devices and those with untreated IAs. Baseline characteristics and outcomes were compared. RESULTS This study included 257 patients with IAs. Of those, 66 patients had previously treated IAs (median time between diagnosis and initial treatment and retreatment: 6.28 months), and 191 patients had untreated IAs. Of the 246 patients with 10.5 months of imaging follow‐up, the core lab adjudicated complete occlusion was less in previously treated IAs compared with untreated IAs (59.7% versus 72.3%; adjusted odds ratio, 0.43 [95% CI, 0.21–0.88]; P = 0.022). Furthermore, we found similar rates of adequate occlusion between previously treated IAs (83.9%) and untreated IAs (82.1%, P = 0.746). There was no difference in rates of major stroke (1.5% versus 2.6%, P>0.999), mortality (1.5% versus 1.0%, P>0.999), modified Rankin Scale score 0–2 (93.7% versus 95.7%, P = 0.504), and retreatment (1.6% versus 3.3%, P = 0.684) between the 2 groups. CONCLUSION Our results revealed reasonable rates of occlusion and an acceptable safety profile for the use of Surpass Evolve to treat previously treated IAs. Future prospective studies with longer follow‐ups are warranted to explore the findings further.
endovascular flow diversion intracranial aneurysm previously treated Surpass Evolve UIOWA OA Agreement

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