Morphological factors and device deformation associated with recurrence in intracranial aneurysms treated with the contour neurovascular system

BACKGROUND AND PURPOSE: The Contour Neurovascular Device is an intrasaccular flow disrupting device designed for the treatment of wide-neck intracranial aneurysms and has been shown to be a safe and effective treatment option. Mid- and long-term results are still scarce, and data on morphological risk factors and device deformation have not been published yet. In this study, we investigate the association of aneurysm-related morphologic parameters and device deformation with recurrence after treatment of intracranial aneurysms with Contour. MATERIALS AND METHODS: All patients with unruptured and ruptured aneurysms that were treated with Contour in our institution were retrospectively identified. Only patients with 3D-rotational angiography, flat-panel detector-CT or CTA on pre-interventional, 24 h post-interventional, and at least one follow-up imaging were included. Morphological parameters and Contour deformation on longitudinal imaging were tested for an association with aneurysm occlusion status. RESULTS: 63 aneurysms were analyzed, the median follow-up time was 17 (range, 2-67) months. Adequate occlusion (BOSS 0-2) on longest follow-up occurred in 79 %, and Contour deformation in 57 %. The parameters neck diameter (p = 0.005, OR 3.1), Contour migration (p = 0.017, OR 9.3) and lateral impression (p = 0.033, OR 5) were significantly and independently associated with deterioration of occlusion status on follow-up imaging. Deformation mostly occurred within a 4 to 6-month follow-up period. CONCLUSIONS: Larger neck diameter and Contour deformation are significantly associated with recurrence after treatment with Contour irrespective of the dome-neck ratio. Assessment of Contour deformation on 3D follow-up imaging seems advisable.