Assessment of intracranial aneurysm neck deformation after contour deployment.

Abstract

Purpose: The contour neurovascular system (CNS) is a novel device to treat intracranial wide-necked bifurcation aneurysms, with few studies assessing its long-term effects. Particularly its impact on aneurysm morphology has not been explored yet. We present a preliminary study to explore this impact for the first time, focusing on the neck curve and ostium of the aneurysm.

Methods: We investigated seven aneurysms treated with the CNS to assess ostium deformation after CNS deployment by comparing models extracted from in vivo medical pre-treatment and follow-up scans via morphological analysis. Time between pre- and follow-up scans was ten months on average. Size and shape indices like area, neck diameter, ellipticity index, undulation index, and more were assessed.

Results: Ostium size was reduced after treatment. On average, ostium area was reduced at a rate of $-$ 0.58 (± 4.88) mm² per year, from 15.52 (± 3.51) mm² to 13.30 (± 2.27) mm², and ostium width from 5.01 (± 0.54) mm to 4.49 (± 0.45) mm, with an average reduction of $-$ 0.59 (± 0.87) mm. This shrinking positively correlated with time passing. Shape deformation was low, though notably mean ellipticity index was reduced by 0.06 (± 0.15) on average, indicating ostia were less elongated after treatment.

Conclusion: We interpret the shrinking of the ostium as part of the healing process. Shape changes were found to be small enough to conclude no shape deformation of the ostium from CNS deployment, but the analysis of more cases with more parameters and information is necessary.