Neurol India. 2026 Jul 1;74(4):629-636. doi: 10.4103/neurol-india.Neurol-India-D-25-00443. Epub 2026 Jul 21.
ABSTRACT
BACKGROUND: Management of wide-necked intracranial aneurysms remains a challenge for clinicians. Intrasaccular devices like Contour and WEB (Woven Endo Bridge) devices offer new promise in managing wide-necked intracranial aneurysms. The Contour Neurovascular System, developed by CERUS Endovascular (Fremont, California, USA), is an intrasaccular device working on the principle of flow-disruption and flow diversion. We report our institutional experience with this device in cases of ruptured intracranial aneurysms.
OBJECTIVE: To investigate the role of the Contour device as a first-line intervention in ruptured intracranial aneurysms, focusing on its safety, efficacy, and patient outcomes.
MATERIALS AND METHODS: This is a retrospective study conducted in the Department of Neurosurgery at Dr. Ram Manohar Lohia Institute of Medical Sciences (RMLIMS), Lucknow, India. A single surgeon operated on all cases. Clinical, radiological, and follow-up data were collected and analyzed for all patients treated with the Contour device. Modified Rankin scale (MRS) was used at 6 weeks to assess the patient's performance. MR angiography (MRA) brain was done at follow-up to assess the aneurysmal occlusion using the Raymond-Roy classification (RROC).
RESULTS: Of the 15 cases of treated ruptured intracranial aneurysms, 10 were anterior communicating artery (ACom) aneurysms, 3 were middle cerebral artery (MCA) bifurcation aneurysms, and 2 were basilar tip aneurysms. The contour device was successfully deployed in all the cases. At 6-month follow-up, MRA revealed that 11 patients had Raymond-Roy Occlusion Classification (RROC) Class I occlusion, 2 patients had neck remnants (RROC Class II), and 1 patient had RROC Class IIIa occlusion with partial aneurysmal reperfusion.
CONCLUSION: Intrasaccular flow disruption is a novel endovascular approach for the treatment of wide necked intracranial aneurysms using devices like Contour. The Contour device demonstrated a favorable safety profile and proved to be a stable and effective treatment option, even in the acute setting of aneurysmal rupture.
PMID:42478396 | DOI:10.4103/neurol-india.Neurol-India-D-25-00443