Introduction: The PulseRider is an innovative stent-like device designed for the treatment of intracranial bifurcation aneurysms. The device is designed to remodel bifurcation points while protecting vessel branches and providing support during coil embolization. The goal of this study was to assess the current evidence on safety and effectiveness of the PulseRider.
Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The following databases were searched: PubMed, Ovid MEDLINE, and Scopus. The search strategy consisted of ‘pulserider’, ‘bifurcation aneurysm’, and ‘endovascular’ in both AND and OR combinations. Studies included in the review were original research articles in peer-reviewed journals. The manuscripts were thoroughly examined and compared on study design, outcomes, and results.
Results: A total of 3 studies were identified describing the use of the PulseRider device in the treatment of 63 patients with 63 bifurcation aneurysms. We identified 2 multicenter case series and 1 single-arm clinical trial. The majority of aneurysms treated were located at the basilar tip (37, 58.7%). All devices were successfully deployed and there were 5 periprocedural complications (7.9%); including 2 intraoperative aneurysm ruptures, 1 vessel dissection, and 2 thrombus formations. Immediate complete aneurysm occlusion was achieved in 61.9% (39/63) of cases and at the 6-month imaging follow-up, 66.7% (42/63) achieved complete aneurysms occlusion. There was 1 recanalization reported in one of the multicenter case series within the 6-month follow-up.
Conclusions: The literature suggests the PulseRider is safe and probably effective for the treatment of intracranial bifurcation aneurysms, however, current evidence is limited to a small sample and short follow-up. In addition, the device has not been compared to other treatment modalities.
Patient Care: Understanding the current status of novel endovascular devices allows the physicians make a better decision making process in the treatment intracranial aneurysms.
Learning Objectives: By the conclusion of this session, participants should be able to:
1) Describe the importance of new technologies for the treatment bifurcation aneurysms.
2) Discuss, in small groups the current evidence of the PulseRider for the treatment of intracranial aneurysms.
3) Identify a useful addition to the endovascular armamentarium.