Improved Occlusion Rate of Intracranial Aneurysms Treated with the Derivo Embolization Device: One-Year Clinical and Angiographic Follow-Up in a Multicenter Study

World Neurosurg. 2019 Jun:126:e1503-e1509. doi: 10.1016/j.wneu.2019.03.137. Epub 2019 Mar 23.

Abstract

Objective: The Derivo Embolization Device (DED) is a novel flow-diverter stent consisting of a flexible structure and a surface modification that aims to reduce thrombogenicity. Here, we report 1-year clinical and angiographic follow-up results of the second-generation DED for the treatment of intracranial aneurysms.

Methods: This is a retrospective study of 59 consecutive patients (mean age: 53 years, 81% women) treated with the DED for 59 aneurysms (mean size: 8.1 mm) between November 2015 and February 2018 at 3 German tertiary care centers. We evaluated the rate of ischemic stroke, functional outcome, and angiographic results during a 1-year follow-up period.

Results: Deployment of the DED was successful in all cases. Adverse events were observed in 6 procedures (10.2%), of which 2 were symptomatic (3.4%). No delayed ischemic or hemorrhagic events occurred during the 1-year follow-up and there were no deaths. Permanent morbidity due to in-stent thrombosis and consecutive ischemic stroke occurred in 1 patient (1.7%). Complete (O'Kelly-Marotta grading scale D) and favorable (O'Kelly-Marotta grading scale C+D) aneurysm occlusion was obtained in 70.5% (31/44) and 88.7% (39/44) at 6 months and 82.8% (24/29) and 100% (29/29) at 12 months, respectively.

Conclusions: Our results demonstrate that treatment of intracranial aneurysms with the DED is associated with low rates of ischemic complications and adequate aneurysm occlusion at 1-year follow-up.

Keywords: Aneurysm; Angiography; Derivo Embolization Device; Flow diverter; Intervention.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain Ischemia / epidemiology
  • Brain Ischemia / etiology
  • Cerebral Angiography
  • Embolization, Therapeutic / instrumentation*
  • Embolization, Therapeutic / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Platelet Aggregation Inhibitors / therapeutic use
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Stroke / epidemiology
  • Stroke / etiology
  • Treatment Outcome
  • Young Adult

Substances

  • Platelet Aggregation Inhibitors