Using the pCANvas neck-bridging device in treating a wide-necked aneurysm of the basilar tip

Abstract

Background and importance The endovascular treatment of recurrent wide-necked bifurcation aneurysms at the basilar tip remains very challenging. Many different techniques and devices have emerged in recent years as potential options but results remain less than controversial. The pCANvas is a relatively new device wielding neck-bridging properties with a haemodynamically active membrane acting as blood flow disrupter. Clinical presentation We present the clinical case of a patient in whom multiple endovascular and microsurgical attempts failed to achieve the definitive treatment of a large and wide-necked basilar tip aneurysm. The patient underwent successful endovascular implantation of the novel pCANvas device across the recurrent aneurysm neck. The device limited the blood flow to the anerysmal lumen and thus promoted faster thrombosis. Third month follow-up confirmed complete obliteration of the aneurysm. Conclusion The application of the pCANvas device offers a potential treatment option in difficult and recurrent aneurysms. The endovascular flow disruption is a relatively new feature aiming to create conditions for intraluminal thrombosis and is certainly promising for the treatment of complex bifurcation aneurysms.

Intrasaccular flow disruption (WEB) of a large wide-necked basilar apex aneurysm using PulseRider-assistance

“…pCONus has been used in a small series of 21 patients with acutely ruptured aneurysms, along with dual antiplatelet therapy, resulting in a 62% rate of modified Raymond-Roy classification 1–2 at immediate angiography [ 20 ]. The pCANvas is a newer derivate of the pCONus with similar structure and delivery but with the added feature of a membrane between each petal, designed to further augment the neck-bridging effect [ 21 , 22 ]. The pCONus and pCANvas are not yet available in the United States.…”