PulseRider Aneurysm Neck Reconstructive Device Versus Other Treatments in Patients With Wide-Neck Bifurcation Aneurysms: A Systematic Review

TL;DR

This review compares the PulseRider device with other treatments for wide-neck brain aneurysms, finding it promising but needing more long-term data.

Contribution

The study provides a systematic comparison of the PulseRider device with existing treatments for wide-neck bifurcation aneurysms.

Findings

PRANRD achieved high initial occlusion rates with low complication rates.

PRANRD-assisted coiling had lower complete occlusion rates at six months compared to Y-stenting.

No procedure-related mortality was observed in the reviewed studies.

Abstract

Wide-neck bifurcation aneurysms (WNBA) are challenging to treat both surgically and endovascularly due to their complex anatomy. The FDA-approved PulseRider Aneurysm Neck Reconstructive Device (PRANRD; Cerenovus, Johnson & Johnson, Irvine, CA, USA) offers a novel endovascular treatment option; however, comparative data on its safety and efficacy remain limited. This review compares PRANRD with other treatment modalities for unruptured WNBA. A search of multiple databases identified 51 articles, of which three met the inclusion criteria, comprising two cohort studies and one case series, for a total of 134 patients treated with PRANRD. The device achieved complete angiographic occlusion in most cases with low complication rates. Compared to Y-stenting, PRANRD-assisted coiling demonstrated similar immediate occlusion rates but lower complete occlusion rates at six months. No procedure-related mortality was reported. However, long-term follow-up and randomized controlled trials are still required. PRANRD appears to be a promising alternative for treating WNBA, offering high occlusion rates and a favorable safety profile. Further research is necessary to confirm its long-term efficacy and safety.

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