Medina® Embolization Device for the Treatment of Intracranial Aneurysms: Safety and Angiographic Effectiveness at 6 Months. Issue 2 (February 2018)

• Record Type: Journal Article
• Authors: Sourour, Nader‐Antoine; Vande Perre, Saskia; Maria, Federico Di; Papagiannaki, Chrysanthi; Gabrieli, Joseph; Pistocchi, Silvia; Bartolini, Bruno; Degos, Vincent; Carpentier, Alexandre; Chiras, Jacques; Clarençon, Frédéric
• Is Part Of: Neurosurgery. Volume 82:Issue 2(2018)
• Publication Date: 2018-02
• Subjects: Medina Embolization Device -- Intrasaccular flow disruption -- Petals -- Intracranial aneurysm; Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyx161
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract : BACKGROUND : The 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. OBJECTIVE : To evaluate the feasibility, safety, and 6‐ to 9‐mo effectiveness of this new device for the treatment of intracranial wide‐necked aneurysms. METHODS : Twelve 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. RESULTS : The 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. CONCLUSION : The 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.