Endovascular treatment of complex bifurcation aneurysms using the pConus device: clinical cases

Abstract

The objective is to present the clinical experience of using the pConus stent-like device in the treatment of complex bifurcation aneurysms.Clinical cases. A 64-year-old patient was admitted with complaints of periodic headache without loss of consciousness and an increase in focal symptoms. Saccular aneurysms of the anterior communicating artery and the left superior cerebellar artery were found without signs of subarachnoid hemorrhage. For occlusion of the aneurysm of the left superior cerebellar artery (dimensions 7.4 х 5.3 mm, neck width 5.0 mm, facing left and up, body/neck ratio 1.48, the branch of the artery branched off from the neck), a pConus device (crown diameter 8 mm) was used with micro-coils.A 61-year-old patient was admitted with complaints of headache in the occipital region, accompanied by repeated vomiting and an increase in blood pressure to 200/110 mm Hg. Subarachnoid hemorrhage and a saccular aneurysm of the basilar artery bifurcation (facing up, anteriorly and somewhat to the left, measuring 4.9 x 3.4 mm, neck width 3.1 mm, dome/neck ratio 1.1) were revealed. A pConus device was used for micro-coils occlusion (4-25-6 mm).In the postoperative period, both patients did not experience an increase in focal neurological symptoms. Control angiography after 6 months confirmed stable occlusion, all major vessels were passable.Conclusion. In the described cases, there were no technical problems during the installation and implantation of the device. The use of the pConus device in the treatment of complex bifurcation aneurysms technically simplifies surgical intervention, since it does not require catheterization of the efferent vessels of the aneurysm.