Periprocedural safety of saccular aneurysm embolization with the Penumbra SMART Coil System: A SMART registry subset analysis

Robert M. Starke, Min S. Park, Richard Bellon, Bradley Bohnstedt, Clemens M. Schirmer, Reade De Leacy, David Fiorella, Albert J. Yoo, Alejandro M. Spiotta

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background: Using data from the SMART registry, we report on periprocedural safety of the Penumbra SMART Coil System for endovascular coil embolization of saccular intracranial aneurysms. Methods: The SMART registry was a prospective, multi-center registry of site standard of care endovascular coiling procedures performed using at least 75% Penumbra SMART Coil, PC400, and/or POD coils. This subset analysis reports on the periprocedural safety outcomes of the saccular intracranial aneurysm cohort. Predictors of rupture/re-rupture or perforation (RRP), thromboembolic complications, and device-or procedure-related adverse events (AEs) were determined in univariate and multivariate analysis. Results: Between June 2016 and August 2018, 851 saccular aneurysm patients (31.0%, 264/851 ruptured) were enrolled across 66 North American centers. Clinically significant (ie, a serious adverse event) RRP occurred in 2.0% (17/851) of cases-1.9% (5/264) for the ruptured cohort and 2.0% (12/587) for the un-ruptured cohort. Clinically significant thromboembolic events occurred in 3.1% (26/851) of cases-5.3% (14/264) for the ruptured cohort and 2.0% (12/587) for the un-ruptured cohort. Multivariate predictors of periprocedural RRP were increased packing density and adjunctive treatment with a balloon. For periprocedural thromboembolic events, multivariate predictors were bifurcation location and ruptured status. For device-or procedure-related AEs, multivariate predictors were bifurcation location and adjunctive treatment with stent or balloon. Conclusion: The low rates of thromboembolic complications and RRP events demonstrate the adequate safety profile of the SMART Coil System to treat cerebral aneurysms in routine clinical practice. Trial registration number: NCT02729740.

Original languageEnglish (US)
Article number016943
JournalJournal of neurointerventional surgery
DOIs
StateAccepted/In press - 2021

Keywords

  • aneurysm
  • coil
  • complication
  • device
  • intervention

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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