Preliminary results of intracranial aneurysm treatment with derivo2heal embolization device

• Published in: Neuroradiology 2024-10, Vol.66 (10), p.1747-1759
• Main Authors: Rueckel, J., Ozpeynirci, Y., Trumm, C., Brem, C., Pflaeging, M., Fischer, T.D., Liebig, T.
• Format: Article
• Language: English
• Subjects: Adverse events; Aneurysm; Aneurysms; Antiplatelet therapy; Carotid arteries; Carotid artery; Effectiveness; Embolization; Fibrin; Heparin; Imaging; Implants; Interventional Neuroradiology; Ischemia; Medicine; Medicine & Public Health; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Occlusion; Radiology; Thromboembolism; Thrombosis
• ISSN: 0028-3940; 1432-1920; 1432-1920
• DOI: 10.1007/s00234-024-03387-y

Introduction The Derivo 2 Heal Embolization Device (D2HED) is a novel flow diverter (FD) providing a fibrin-/heparin-based surface coating aiming at lower thrombogenicity. We evaluate periprocedural aspects and preliminary aneurysm occlusion efficacy for intracranial aneurysm treatment. Methods Thirty-four D2HEDs deployments (34 aneurysms, 32 patients) between 04/2021 and 10/2023 were analyzed. All patients were under dual antiplatelet therapy (dAPT). Periprocedural details, adverse events, and follow-up (FU) imaging were reviewed by consultant-level neuroradiologists. Complication rates and aneurysm occlusion efficacy are compared with performance data of other FDs based on literature research. Results Each intervention succeeded in the deployment of one D2HED. Significant and/or increased intraaneurysmal contrast stagnation immediately after D2HED deployment was seen in 73.5% of cases according to O’Kelly-Marotta (OKM) grading scale. Clinically relevant early adverse events occurred in three patients: Among them two cases with fusiform aneurysms in the posterior circulation (ischemic events, early in-stent-thrombosis) and one patient (ischemic event) out of the majority of 31 treated internal carotid artery aneurysms (3,2%). Regarding mid-term FU (> 165 days), one aneurysm did not show progressive occlusion presumably caused by a prominent A1 segment arising from the terminal ICA aneurysm itself. Apart from that, mid-term complete / partial occlusion rates of 80% / 20% could be demonstrated. Conclusion Our case series - although suffering from restricted sample size - suggests a potential effectiveness of D2HED in managing intracranial aneurysms. Further studies with larger samples are warranted to quantify long-term occlusion efficacy and the impact of antithrombogenic surface coating on the necessary (d)APT.