• Journal of neurosurgery · Feb 2021

    Early experience with a novel net temporary bridging device (Cascade) to assist endovascular coil embolization of intracranial aneurysms.

    • Alejandro Tomasello, David Hernandez, Laura Ludovica Gramegna, Sonia Aixut, Barranco PonsRogerR4Department of Neuroradiology, Hospital Universitari de Bellvitge de Llobregat, Barcelona, Spain., Olav Jansen, Michal Zawadzki, Antonio Lopez-Rueda, Carmen Parra-Fariñas, Carlos Piñana, Lavinia Dinia, Fuat Arikan, and Alex Rovira.
    • 1Interventional Neuroradiology Section, Department of Radiology, Vall d'Hebron University Hospital, Barcelona.
    • J. Neurosurg. 2021 Feb 1; 134 (2): 591599591-599.

    ObjectiveThe goal of this study was to evaluate the effectiveness and safety of a new noncompletely occlusive net-assisted remodeling technique in which the Cascade net device is used for temporary bridging of intracranial aneurysms.MethodsBetween July 2018 and May 2019, patients underwent coil embolization with the Cascade net device within 4 centers in Europe. Analysis of angiographic (modified Raymond-Roy classification [MRRC]) and clinical outcomes data was conducted immediately following treatment and at the 6-month follow-up.ResultsFifteen patients were included in the study (mean age 58 ± 13 years, 11/15 [73.3%] female). Ten patients had unruptured aneurysms, and 5 presented with ruptured aneurysms with acute subarachnoid hemorrhage. The mean aneurysm dome length was 6.27 ± 2.33 mm and the mean neck width was 3.64 ± 1.19 mm. Immediately postprocedure, MRRC type I (complete obliteration) was achieved in 11 patients (73.3%), whereas a type II (residual neck) was achieved in 4 patients (26.7%). Follow-up examination was performed in 7/15 patients and showed stabilization of aneurysm closure with no thromboembolic complications and only 1 patient with an increased MRRC score (from I to II) due to coil compression.ConclusionsInitial experience shows that the use of a new noncompletely occlusive net-assisted remodeling technique with the Cascade net device may be safe and effective for endovascular coil embolization of intracranial aneurysms.

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