• Nader-Antoine Sourour, Saskia Vande Perre, MariaFederico DiFDDepartment of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France., Chrysanthi Papagiannaki, Joseph Gabrieli, Silvia Pistocchi, Bruno Bartolini, Vincent Degos, Alexandre Carpentier, Jacques Chiras, and Frédéric Clarençon.
• Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France.
• Neurosurgery. 2018 Feb 1; 82 (2): 155-162.

BackgroundThe Medina Embolization Device (MED) is a new concept device that combines the design of a detachable coil and the one of an intrasaccular flow disruption device.ObjectiveTo evaluate the feasibility, safety, and 6- to 9-mo effectiveness of this new device for the treatment of intracranial wide-necked aneurysms.MethodsTwelve patients (10 females, mean age = 56 yr) with 13 wide-necked intracranial aneurysms (3 ruptured; 10 unruptured) were treated by means of the MED from January 2015 to October 2015. In 15% of the cases, MEDs were used in a standalone fashion; in 85% of the cases, additional regular coils were used. Adjunctive compliant balloon was used in 4 of 13 cases (31%). Procedure-related complications were systematically recorded; discharge and 6- to 9-mo follow-up modified Rankin Scale was assessed. Angiographic follow-up was performed with a mean delay of 5.5 ± 1.7 mo. Occlusion rate was evaluated in postprocedure and at midterm follow-up using the Roy-Raymond scale.ResultsThe deployment of the MED was feasible in all cases. No perforation was recorded. One case of thromboembolic complication was observed in a ruptured anterior communicating artery aneurysm, without any clinical consequence at follow-up. Grade A occlusion rate was 61.5% in postprocedure and 83% at 6-mo follow-up. Two cases (17%) of recanalization were documented angiographically.ConclusionThe MED is a new generation device combining the design of a detachable coil and an intrasaccular flow disruption device. According to our early experience, this device is safe and provides a satisfactory occlusion rate at angiographic follow-up of 6 mo.Copyright © 2017 by the Congress of Neurological Surgeons

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