• B Gory, M Aguilar-Pérez, E Pomero, F Turjman, W Weber, S Fischer, H Henkes, and A Biondi.
• From the Department of Interventional Neuroradiology (B.G., F.T.), Neurologic Hospital Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.
• AJNR Am J Neuroradiol. 2015 Sep 1; 36 (9): 1735-40.

Background And PurposeEndovascular treatment of bifurcation middle cerebral artery aneurysms with a wide neck could be challenging, and many lesions are still treated by a surgical approach. The pCONus is a newly emerging device for wide-neck bifurcation intracranial aneurysms. To date, a single report on the treatment of intracranial aneurysms including all locations has been published. We report our experience with pCONus in the treatment of wide-neck MCA aneurysms.Materials And MethodsMCA aneurysms treated with pCONus in 4 European centers were retrospectively reviewed.ResultsForty MCA aneurysms (mean dome size, 7.7 mm; mean neck size, 5.6 mm) were treated in 40 patients (mean age, 62 years). Aneurysm coiling was performed after deployment of 1 pCONus in 95% (38/40) of cases and after deployment of 2 pCONus devices in 5% (2/40). No procedural angiographic complications were observed. Reversible neurologic complications were noted in 5% (2/40), and permanent neurologic complication, in 2.5% (1/40) at 1 month. There was no mortality. No aneurysms bled or rebled after treatment. Immediate angiographic results were complete aneurysm occlusion in 25% (10/40), neck remnant in 47.5% (19/40), and aneurysm remnant in 27.5% (11/40). Follow-up (mean, 6.8 months) was available for 33 aneurysms (82.5%). Stable or improved results were observed in all except 3 cases, including 48.5% complete occlusions (16/33), 30.3% neck remnants (10/33), and 21.2% aneurysm remnants (7/33). There was no in-stent stenosis or jailed branch occlusion. There was no angiographic recurrence of initially totally occluded aneurysms.ConclusionsMCA aneurysms with a wide neck are amenable to treatment with pCONus.© 2015 by American Journal of Neuroradiology.

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