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Case Reports

Contour Neurovascular System™ UK Experience 

Author and Institution

Dr Tufail Patankar

Consultant Interventional Neuroradiologist

Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust

Honorary Senior Lecturer, University of Leeds

 

Case Description

Female, 71 years old.

Unruptured treatment of Left ICA termination aneurysm.

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Case History

Incidentally detected (MRA) Left Internal Carotid Artery (ICA) 

termination aneurysm.

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Previous coiling of acute Anterior Communicating

Artery aneurysm (ACOM) with Sub-Arachnoid Haemorrhage (SAH).

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Treatment Options

  • Balloon-assisted coiling

  • Stent-assisted coiling

  • WEB device (MicroVention)

  • pCONus device (Phenox)

  • Surgery

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During a multi-disciplinary team meeting, all treatment options

were discussed. It was decided to use the Contour Neurovascular System™.

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There are several advantages of the Contour Neurovascular System. Patients potentially avoid the need for a dual antiplatelet therapy regimen, as well as the risks associated with balloon-assisted coiling in Middle Cerebral Artery (MCA) territory.

Additionally, the procedure time is short and can lead to complete obliteration of the aneurysm upon deployment.

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Treatment technique

Access:

  • Right trans femoral catheterization.

  • 8F sheath placed in right common femoral artery.

  • 6F Neuron MAX (Penumbra, Inc) placed in left internal carotid artery for proximal support.

  • 6F Navien (Medtronic Neurovascular) was used for distal support.

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A 3D rotational angiogram was performed. The aneurysm was carefully measured, and diameters taken in both AP and lateral planes.

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Sizing of aneurysm

Sizing of the Aneurysm

Anterior Posterior (AP) Diameter: 5.5 mm, Neck: 3.8 mm

Lateral (LAT) Diameter: 5.4 mm

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Following careful measurement of the aneurysm, it was decided to utilize a 7 mm Contour device. An XT-27 micro-catheter from Stryker Neurovascular was tracked over a 0.014 Synchro Guidewire, also from Stryker Neurovascular, and carefully navigated into the centre of the aneurysm.

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A 7 mm Contour Neurovascular System™ was Implanted.

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Immediate stasis was observed within the aneurysm.

No immediate complications were encountered.

Total fluoroscopic time was 16 minutes.

Post-procedure

  • The patient was discharged home in 24 hours with no neurological deficit and mRS 0.

  • Six-week clinic follow up mRS 0.

  • The patient was asymptomatic with no neurological deficit.

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Imaging and Clinical Follow Up Results

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MRA at six-month follow up:

The Left ICA termination appears well occluded on MR and TOF MRA (Raymond Scale 1). The artifact from the device precludes assessment of the aneurysm although there was no signal or flow seen within the aneurysm. Clinical six-month follow up catheter angiogram: Patient was asymptomatic mRS 0 in neurovascular clinic six months following the procedure.

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Download the full case report here

Indications for Use

The Contour Neurovascular System™ is indicated for the endovascular embolization of intracranial aneurysms.

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Caution:  Products are investigational only and are not available for sale in the United States or European Union.

Contour Neurovascular System™ is a registered trademark of Cerus Endovascular, Inc. Prior to use, refer to the Instructions for Use supplied with products for indications, contraindications, warnings, precautions, and suggested procedure.

©2019 Cerus Endovascular, Inc. All rights reserved. 

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