{
  "abstract": "Background and objectives Intracranial wide neck bifurcation aneurysms treated with intrasaccular devices can have recurrences, with adverse morphologies, that are challenging to manage. We report our initial experience of the latest generation endovascular clip system (eCLIPs) (eVasc, Vancouver, British Columbia, Canada) device in treating these complex lesions.Methods A prospectively maintained registry was reviewed for patients that were initially treated with a Woven EndoBridge (WEB) (Microvention, Aliso Viejo, California, USA), Contour (Cerus Endovascular, Fremont, California, USA), or Artisse (Medtronic, Irvine, California, USA) intrasaccular device, and subsequently underwent retreatment with an eCLIPs implant. The following data were analyzed: aneurysm location, recurrence dimensions, dome-to-neck and aspect ratios, rupture status, procedural time metrics, complications, anti-platelet medication, baseline and 6 month modified Rankin Scores (mRS), angiographic outcome and follow-up using modified Raymond-Roy Occlusion Classification (mRROC).Results Twenty-one aneurysm recurrences across 21 patients were treated between October 2022 and December 2024. eCLIPs was successfully deployed in all cases intended for retreatment with the device. Primary treatment was performed using a WEB (n=14), Contour (n=5) or Artisse device (n=2). The median aneurysm recurrence size was 7.0 mm (range: 2.1 mm-10.3 mm). The median aspect ratio was 0.87 (range: 0.50–2.24) and the median dome-to-neck ratio 1.16 (range: 0.53–1.69). Of the 13 patients with available follow-up (median duration=11 months), all had adequate occlusion (10 were mRROC=1, and three were mRROC=2). There were no device related safety events.Conclusion The new generation eCLIPs can be used safely and with a high rate of technical success for a range of bifurcation aneurysm recurrences initially treated with an intrasaccular device. While treatment durability appears promising, further long-term prospective studies are needed to confirm these findings.",
  "authors": [
    {
      "affiliations": [
        "Interventional Neuroradiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK"
      ],
      "name": "Waleed Butt"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK"
      ],
      "name": "Mohammad Al-Tibi"
    },
    {
      "affiliations": [
        "Neuroradiology, Hopital Fondation Adolphe de Rothschild, Paris, France"
      ],
      "name": "Amira Al Raaisi"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK"
      ],
      "name": "Essam Hashem"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK"
      ],
      "name": "Michael Adeleye"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Queen Elizabeth Hospital Birmingham, Birmingham, UK"
      ],
      "name": "Ming Yao Chong"
    },
    {
      "affiliations": [
        "Neurosurgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK"
      ],
      "name": "Rosa Sun"
    },
    {
      "affiliations": [
        "Neurosurgery, Queen Elizabeth Hospital Birmingham, Birmingham, UK"
      ],
      "name": "Kway Zayar Thant"
    },
    {
      "affiliations": [
        "Department for Radiology and Neuroradiology, KRH Klinikum Nordstadt, Hanover, NDS, Germany"
      ],
      "name": "Joerg Hattingen"
    },
    {
      "affiliations": [
        "Department of Interventional Neuroradiology, Fondation Rothschild Hospital, Paris, Paris, France"
      ],
      "name": "Raphaël Blanc"
    },
    {
      "affiliations": [
        "Department of Neuroradiology, Royal Hallamshire Hospital, Sheffield, England, UK"
      ],
      "name": "Richard Dyde"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Royal Victoria Hospital, Belfast, Northern Ireland, UK"
      ],
      "name": "Ian Rennie"
    },
    {
      "affiliations": [
        "Neuroradiology Department, University Hospital Centre Nantes, Nantes, Pays de la Loire, France"
      ],
      "name": "Romain Bourcier"
    },
    {
      "affiliations": [
        "Neuroendovascular Program, Neurointerventional & Neuroanalytics Collaboration (NAN-C). School of Medicine, Toronto Metropolitan University, Toronto, Ontario, Canada",
        "Neuroendovascular Program, Brigham and Women’s Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Adam A Dmytriw"
    },
    {
      "affiliations": [
        "Neuroradiology, Asklepios Hospitals St. Georg and Wandsbek, Hamburg, Hamburg, Germany"
      ],
      "name": "Jan-Hendrik Buhk"
    },
    {
      "affiliations": [
        "Neuroradiology, University Hospital Cologne, Neuroradiology Koeln, Germany, Koeln, Germany"
      ],
      "name": "Christoph Kabbasch"
    },
    {
      "affiliations": [
        "Division of Neurosurgery, Departments of Surgery & Medical Imaging, St Michael’s Hospital, Toronto, Ontario, Canada"
      ],
      "name": "Vitor Mendes Pereira"
    },
    {
      "affiliations": [
        "Neurosurgery, Radboud Univ Nijmegen, Nijmegen, Netherlands"
      ],
      "name": "Joost De Vries"
    },
    {
      "affiliations": [
        "Interventional Neuroradiology, Queens Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, UK"
      ],
      "name": "Tufail Patankar"
    }
  ],
  "title": "eCLIPs treatment of intrasaccular device recurrences in wide neck bifurcation aneurysms: multicenter experience with the new generation device",
  "uid": "b93382d8-87b3-5131-8d18-5b9b87abbdb9"
}