NYMC Faculty Publications

Safety and Efficacy of the Surpass Streamline for Intracranial Aneurysms (SESSIA): A Multi-Center US Experience Pooled Analysis

Authors

Juan Vivanco-Suarez, Department of Neurology, Neurosurgery & Radiology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Alan Mendez-Ruiz, Department of Neurology, Neurosurgery & Radiology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Mudassir Farooqui, Department of Neurology, Neurosurgery & Radiology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Kimon Bekelis, Department of Neurological Surgery, Good Samaritan Hospital Medical Center, West Islip, NY, United States.
Justin A. Singer, Department of Neurological Surgery, Spectrum Health, Grand Rapids, MI, United States.
Kainaat Javed, Department of Neurological Surgery, Montefiore Medical Center, Bronx, NY, United States.
David J. Altschul, Department of Neurological Surgery, Montefiore Medical Center, Bronx, NY, United States.
Johanna T. Fifi, Department of Neurological Surgery, The Mount Sinai Hospital, New York, NY, United States.
Stavros Matsoukas, Department of Neurological Surgery, The Mount Sinai Hospital, New York, NY, United States.
Jared Cooper, Department of Neurology, Neurosurgery & Radiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States.
Fawaz Al-Mufti, Department of Neurology, Neurosurgery & Radiology, Westchester Medical Center and New York Medical College, Valhalla, NY, United States.
Bradley Gross, Department of Endovascular Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Brian Jankowitz, Department of Endovascular Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.
Peter T. Kan, Department of Neurological Surgery, University of Texas Medical Branch, Galveston, TX, United States.
Muhammad Hafeez, Department of Neurological Surgery, University of Texas Medical Branch, Galveston, TX, United States.
Emanuele Orru, Department of Interventional Neuroradiology, Lahey Hospital & Medical Center, Burlington, MA, United States.
Andres Dajles, Department of Neurology, Neurosurgery & Radiology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Milagros Galecio-Castillo, Department of Neurology, Neurosurgery & Radiology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Cynthia B. Zevallos, Department of Neurology, Neurosurgery & Radiology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.
Ajay K. Wakhloo, Department of Interventional Neuroradiology, Lahey Hospital & Medical Center, Burlington, MA, United States.
Santiago Ortega-Gutierrez, Department of Neurology, Neurosurgery & Radiology, The University of Iowa Hospitals and Clinics, Iowa City, IA, United States.

Author Type(s)

Faculty

Journal Title

Interventional Neuroradiology

First Page

589

Last Page

598

Document Type

Article

Publication Date

10-1-2023

Department

Neurosurgery

Second Department

Neurology

Abstract

BACKGROUND AND PURPOSE: Flow diversion has established as standard treatment for intracranial aneurysms, the Surpass Streamline is the only FDA-approved braided cobalt/chromium alloy implant with 72-96 wires. We aimed to determine the safety and efficacy of the Surpass in a post-marketing large United States cohort. MATERIALS AND METHODS: This is a retrospective multicenter study of consecutive patients treated with the Surpass for intracranial aneurysms between 2018 and 2021. Baseline demographics, comorbidities, and aneurysm characteristics were collected. Efficacy endpoint included aneurysm occlusion on radiographic follow-up. Safety endpoints were major ipsilateral ischemic stroke or treatment-related death. RESULTS: A total of 277 patients with 314 aneurysms were included. Median age was 60 years, 202 (73%) patients were females. Hypertension was the most common comorbidity in 156 (56%) patients. The most common location of the aneurysms was the anterior circulation in 89% (279/314). Mean aneurysm dome width was 5.77 ± 4.75 mm, neck width was 4.22 ± 3.83 mm, and dome/neck ratio was 1.63 ± 1.26. Small-sized aneurysms were 185 (59%). Single device was used in 94% of the patients, mean number of devices per patient was 1.06. At final follow-up, complete obliteration rate was 81% (194/239). Major stroke and death were encountered in 7 (3%) and 6 (2%) cases, respectively. CONCLUSION: This is the largest cohort study using a 72-96 wire flow diverter. The Surpass Streamline demonstrated a favorable safety and efficacy profile, making it a valuable option for treating not only large but also wide-necked small and medium-sized intracranial aneurysms.

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