One-year clinical and radiologic outcomes of Surpass Evolve flow diverter for large unruptured intracranial aneurysms

Abstract

Background: Surpass Evolve Flow Diverter (SE-FD; Stryker Neurovascular, Kalamazoo, MI, USA) was launched in 2019 as a new generation FD of Surpass Streamline. The aim of this study was to report the effectiveness and safety of SE-FD insertion for unruptured intracranial aneurysm at one-year follow-up.

Methods: Between November 2019 and October 2021, a total of 106 patients with 108 aneurysms were treated with FD in single institution. Of these, SE-FD insertion was performed in 40 patients with 41 aneurysms. At one-year follow-up, clinical and angiographic outcomes were retrospectively evaluated from electronic medical record and aneurysm database.

Results: There were 12 male and 28 female patients (mean age 59.1 years, 95% CI: 55.3-62.9). Fusiform aneurysm dissection was 46.3% (19/41). Mean maximum aneurysm diameter was 13.2 mm (SD 5.53), and 34.1% (14/41) of aneurysms were 15 mm or bigger. Among 41 aneurysms, complex aneurysm (recurred, thrombosed, or branch artery-incorporated) was accounted for 41.5% (17/41). All procedures were successfully conducted with 7.3% (3/41) of procedure-related complications. At one-year follow-up (N.=40), neurologic morbidity was noted in 2 cases (5.0%; both with modified Rankin Scale [mRS] 1) without any mortality. At one-year follow-up (N.=41), radiologic outcomes were adequate occlusion in 33 (80.5%) and complete occlusion in 29 (70.7%). There was no retreatment in our cohort.

Conclusions: Surpass Evolve Flow Diverter seemed to be safe and effective for the treatment of dissecting/fusiform or complex aneurysms at one-year follow-up. However, further study is needed to evaluate long term results.