Surpass Evolve Flow Diverter for the Treatment of Intracranial Aneurysm: A Systematic Review

Abstract

Purpose: This systematic review aims to summarize the evidence investigating the effectiveness and safety of the Surpass Evolve-Flow Diverter (SE-FD) to treat brain aneurysms. Method: We searched MEDLINE, EMBASE, CINAHL, Web of Science, and Cochrane Library from January 2019 to 29 March 2022. Terms related to the “intracranial aneurysm” and “surpass evolve flow diverter” concepts were used to search the databases; Medical Subject Headings (MeSH) and reference hand search were also utilized. Results: The searches primarily identified 1586 documents. A total of five studies (four case series and one cohort) were included in this review. In the included studies, 192 (74 male and 118 females) patients with 198 aneurysms were involved. In total, 153 SE-FDs were used to treat 145 aneurysms. Complete occlusion was achieved in 69/145 (48%) cases and near-complete occlusion in 24/145 (17%) cases from aneurysms treated with SE-FD. Reported postoperative complications included stent thrombosis (n = 4 patients), hemorrhage (n = 5 patients), ischemia (n = 9 patients), and neurological complications (n = 12 patients). In total, four deaths were reported with only one related to the SE-FD procedure. Conclusion: The results of this review are based on observational data, due to the absence of clinical trials. The findings of the included studies suggest that the effectiveness of the SE-FD procedure is lower than previous FDs but the safety is similar. The included studies also suggested that SE-FD has navigability and resistance to twisting, which makes the procedure an easier method to treat aneurysms that are proximal and distal to the circle of Willis deployment. This review highlights the urgency to conduct clinical trials to confirm these suggestions.

Acute Distal Migration and Shortening of the Flow-Redirection Endoluminal Device: A Case Report

“…Many papers have demonstrated the effectiveness of the FDs. [3][4][5][6][7][8][9] In a systematic review of the FDs, Briganti et al reported that the rate of aneurysm occlusion progressively increased up to 81.5% over a mean follow-up period of 9-months. They also reported the neurologic morbidity within allowance (3.5%), rate of hemorrhagic complication (2.9%), and rate of non-negligible thromboembolic complications (4.1%).…”

Systematic Review and Meta-Analysis of Endovascular Therapy Effectiveness for Unruptured Saccular Intracranial Aneurysms

“…The most prominent inventions include bioactive and hydrogel-coated GDCs and flow diverters. 7,8 For flow diverters, numerous devices have emerged in two categories: (i) extra-saccular: including the p64, 9 the Pipeline, 10 the Flow Redirection Endoluminal Device (FRED), 11 the Surpass, 12 among others; and (ii) intra-saccular flow diverters: such as the Woven EndoBridge (WEB) 13 and the Contour. 14 The advance of this technology has evolved the application of endovascular therapy for complex aneurysm geometries and even aneurysm locations within the neuro-vasculature.…”