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Early clinical experience of using the Surpass Evolve flow diverter in the treatment of intracranial aneurysms

  • Interventional Neuroradiology
  • Published:
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Abstract

Purpose

Here, we presented our early experience with flow diversion procedures using the Surpass Evolve flow diverter (SE, Stryker) and reported the feasibility and safety profile compared to those of a control group treated with other types of flow diverters.

Methods

We included 31 and 53 consecutive flow diversion procedures performed using the SE and other commercial flow diverters, respectively, to treat intracranial aneurysms at our institution. We used two commercial flow diversion systems in the comparison group: the pipeline embolization device and Surpass Streamline.

Results

In the SE group, technical failures occurred in three (9.7%) cases, due to either incomplete wall apposition (n = 1, 3.2%) or stent migration (n = 2, 6.5%). Major complications occurred in four (12.9%) cases: delayed rupture of the target aneurysm (n = 1, 3.2%), major ischemic stroke (n = 1, 3.2%), sudden death from an unidentified cause (n = 1, 3.2%), and parent artery occlusion with stent thrombosis (n = 1, 3.2%). Balloon angioplasty was performed in eight (25.8%) cases. On post-procedure MRI, a DWI-positive lesion was detected in three (9.7%) cases. After multivariate adjustment, the SE group was independently associated with less procedural time of ≥ 90 min (adjusted OR, 0.09; 95% CI, 0.03–0.29; p < 0.001), balloon angioplasty (adjusted OR, 0.22; 95% CI, 0.07–0.75; p = 0.015), and DWI-positive lesions (adjusted OR, 0.04; 95% CI, 0.01–0.19; p < 0.001).

Conclusion

The SE is safe and easy to deploy.

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Availability of data and material

The study data can be obtained from the corresponding author upon reasonable request.

Abbreviations

CI:

Confidence interval

DSA:

Digital subtraction angiography

DWI:

Diffusion-weighted imaging

ICA:

Internal carotid artery

MRI:

Magnetic resonance imaging

OR:

Odds ratio

PED:

Pipeline embolization device

SE:

Surpass Evolve flow diverter

SS:

Surpass Streamline flow diverter

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Authors and Affiliations

  1. Department of Neurosurgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea

    Tae Keun Jee, Je Young Yeon, Jong-Soo Kim & Seung-Chyul Hong

  2. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea

    Keon Ha Kim & Pyoung Jeon

Authors
  1. Tae Keun Jee
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  4. Jong-Soo Kim
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Correspondence to Pyoung Jeon.

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Conflict of interest

The authors declare no competing interests.

Ethics approval

This study was approved by the institutional review board (IRB File No. 2021–01-176–001). All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Consent to participate

A waiver of consent was approved by the institutional review board (IRB File No. 2021–01-176–001). This study involves no more than minimal risk to the subject and the waiver will not adversely affect the rights and welfare of the subjects.

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Jee, T.K., Yeon, J.Y., Kim, K.H. et al. Early clinical experience of using the Surpass Evolve flow diverter in the treatment of intracranial aneurysms. Neuroradiology 64, 343–351 (2022). https://doi.org/10.1007/s00234-021-02793-w

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  • DOI: https://doi.org/10.1007/s00234-021-02793-w

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