E-033 Outcomes of intracranial carotid artery aneurysms treated with novel second generation coils: results from the SMART registry

Background Flow diversion is a viable treatment modality for the embolization of proximal intracranial carotid artery aneurysms (cavernous, superior hypophyseal, ophthalmic). In this study, we evaluated the outcomes of patients with internal carotid artery (ICA) aneurysms who were treated with using novel second generation coils in the SMART registry. Methods We reviewed the multicenter, prospective SMART registry that enrolled patients who underwent endovascular treatment using Penumbra SMART™ Coils. Study endpoints include peri-procedural device-related serious adverse events, the occlusion status immediately post procedure as well as a follow-up angiogram after one year. We included only patients who underwent coiling for intracranial carotid aneurysms in this analysis. Results Out of 906 patients included in the SMART registry, 131 (14.5%) patients were treated for cavernous, ophthalmic, or superior hypophyseal artery aneurysms (age 56.7 ±12.7 yr, 88.5% were females, and 7.6% were ruptured). Most of the aneurysms were wide-necked (defined as an aneurysm with a dome-to-neck ratio less than 2.0 and/or a neck length of 4 mm or more) (86 patients, 65.6%). Sixty patients (45.8%) underwent stent-assisted coiling and 21 patients (16%) underwent balloon-assisted coiling. Device related serious adverse effects were noticed in one patient (0.8%) and periprocedural mortality occurred in one patient (0.8%). Immediate Raymond class I was achieved in 37 patients (28.2%) and one-year Raymond class I was achieved in 56/79 patients (70.9%). One-year recanalization occurred in 8 patients (6.1%). Conclusions In this large, contemporary multicenter registry of patients, coil embolization using the SAMRT coils offers a reasonably safe and effective treatment of intracranial ICA aneurysms, as demonstrated by the high rates of complete one-year aneurysm occlusion and the low rate of recanalization and complications. Disclosures E. Almallouhi: None. M. Anadani: None. S. Al kasab: None. M. Sattur: None. A. Spiotta: 2; C; Penumbra, Cerenovus, Minnetronix.