Height-preserving sizing method for the new Artisse intrasaccular device based on early findings from 26 cases of intracranial aneurysm embolization
Chew, Han Seng Al-Ali, Samer Butler, Benjamin Chavda, Swarupsinh Lamin, Saleh
Chew, Han Seng
Al-Ali, Samer
Butler, Benjamin
Chavda, Swarupsinh
Lamin, Saleh
Affiliation
University Hospitals Birmingham NHS Foundation Trust
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Publication date
2025-05-02
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Abstract
Background and purpose: With the recent relaunch of Artisse 2.0, optimal sizing strategies for the device are still being refined. The official sizing chart covers only taller-than-wide aneurysms within a limited diameter range of 3.4-6 mm. To expand its applicability, we propose an intuitive sizing strategy emphasizing the importance of preserving the device's natural height.
Materials and methods: Patients treated with the Artisse 2.0 between November 2022 and October 2024 were retrospectively analyzed.
Results: Among 26 aneurysms treated over a 24-month period, 13 exhibited varying degrees of 'dog-ear' formation on post-deployment imaging. These cases showed greater width oversizing (+2.06 vs +1.29 mm, P<0.05) and height reduction (-1.83 vs -0.53 mm, P<0.05) compared with cases with complete neck coverage. Similarly, 9 out of the 16 aneurysms with at least one surveillance imaging failed to achieve complete angiographic occlusion. These cases were also associated with greater width oversizing (+1.72 vs +1.43 mm, P=0.47) and height reduction (-2.18 vs -0.81 mm, P=0.052).
Conclusion: In contrast to the Woven EndoBridge (WEB) device, excessive lateral compression and height reduction appear to undermine the stability of the Artisse 2.0. As a result, the device size for spherical or ovoid aneurysms can be determined using the '+1/-1' method, while the '+1/-0' approach is recommended for cylindrical aneurysms to improve neck coverage through height preservation. These proposed sizing strategies may serve as a practical interim solution until more clinical data and user experience become available.
Citation
Chew HS, Al-Ali S, Butler B, Chavda S, Lamin S. Height-preserving sizing method for the new Artisse intrasaccular device based on early findings from 26 cases of intracranial aneurysm embolization. J Neurointerv Surg. 2025 May 2:jnis-2025-023082. doi: 10.1136/jnis-2025-023082. Epub ahead of print.
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Article