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The LUNA aneurysm embolization system for intracranial aneurysm treatment: short-term, mid-term and long-term clinical and angiographic results. | LitMetric

AI Article Synopsis

  • Intrasaccular aneurysm flow disruption is a new endovascular treatment for intracranial aneurysms, specifically evaluated in a study using the LUNA aneurysm embolization system (AES).
  • The study enrolled 63 subjects with 64 aneurysms, primarily focusing on bifurcation and sidewall types, and measured outcomes like aneurysm occlusion and patient disability over time.
  • Results showed that while immediate occlusion rates were low, long-term occlusion improved to about 78% at 12 months and 79% at 36 months, with acceptable safety profiles and minimal morbidity.

Article Abstract

Background And Purpose: Intrasaccular aneurysm flow disruption represents an emerging endovascular approach to treat intracranial aneurysms. The purpose of this study was to determine the clinical and angiographic outcomes of using the LUNA aneurysm embolization system (AES) for treatment of intracranial aneurysms.

Materials And Methods: The LUNA AES Post-Market Clinical Follow-Up study is a prospective, multicenter, single-arm study that was designed to evaluate device safety and efficacy. Bifurcation and sidewall aneurysms were included. Aneurysm occlusion was assessed using the Raymond-Roy classification scale. Disability was assessed using the Modified Rankin Scale (mRS). Morbidity was defined as mRS >2 if baseline mRS ≤2, increase in mRS of 1 or more if baseline mRS >2, or mRS >2 if aneurysm was ruptured at baseline. Clinical and angiographic follow-up was conducted at 6, 12 and 36 months.

Results: Sixty-three subjects with 64 aneurysms were enrolled. Most aneurysms were unruptured (60/63 (95.2%)); 49 were bifurcation or terminal (49/64 (76.6%)). Mean aneurysm size was 5.6±1.8 mm (range, 3.6-14.9 mm), and mean neck size was 3.8±1.0 mm (range, 1.9-8.7 mm). Though immediate postoperative adequate occlusion was low (11/63, 18%), adequate occlusion was achieved in 78.0% (46/59) and 79.2% (42/53) of the aneurysms at 12 months and 36 months, respectively. Four patients were retreated by the 12-month follow-up (4/63 (6.3%)) and three patients were retreated by the 36-month follow-up (3/63 (4.8%)). There were two major strokes (2/63 (3.2%)), one minor stroke (1/63 (1.6%)) and three incidents of intracranial hemorrhage in two subjects (2/63 (3.2%)) prior to the 12-month follow-up. There was one instance of mortality (1/63, 1.6%). Morbidity was 0% (0/63) and 1.8% (1/63) at the 12-month and 36-month follow-ups, respectively.

Conclusions: LUNA AES is safe and effective for the treatment of bifurcation and sidewall aneurysms.

Clinical Trial Registration: ISRCTN72343080; Results.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6288707PMC
http://dx.doi.org/10.1136/neurintsurg-2018-013767DOI Listing

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