Intracranial Coiling Device Assists Aneurysm Embolization

An adjustable remodeling device acts as a temporary bridge to aid in aneurysm coiling while minimizing the risk of coil protrusion or prolapse.

The Rapid Medical (Yokneam, Israel) Comaneci is a temporary device used to mechanically assist in the embolization of intracranial neurovasculature aneurysms with embolic coils. The fully visible aneurysm device is composed of a wire mesh stent permanently affixed to the end of a pusher wire. It is delivered using an endovascular approach; once in place, the internal core wire is withdrawn distally, thus expanding the mesh and blocking the neck of the aneurysm temporarily. Once the coiling procedure has been successfully completed, the device is removed from the parent artery.

Features include a non-occlusive design that maintains blood supply to the brain; stable position and microcatheter support; adjustable proprietary FlexiBraid technology that provides incremental shaping control; high vessel compliance; and 100% radiopaque wires that provide real-time feedback. Three sizes are available; Comaneci, with a net length of 32 mm, suitable for vessels with a diameter of 1.5 - 4.5 mm; Comaneci Petit, with a net length of 24 mm, suitable for vessels with a diameter of 1.5 - 3.5 mm; and Comaneci 17, with a net length of 22 mm, suitable for vessels with a diameter of 0.5 - 3 mm.

“The neurovascular field is the future of endovascular treatment, and in many ways resonates with the cardiology of two years ago. Neurovascular treatment will be the next cardiology, so that was basically the notion with which we started the company,” said Ronen Eckhouse, CEO of Rapid Medical. “We had a few ideas, all in the ischemic stroke market, and then we started working on our first device, Comaneci, for aneurysm treatment.”

“I am excited about having the Comaneci in the United States,” said Professor Peter Nelson, MD, chief of interventional neuroradiology at NYU Langone Medical Center (New York; USA). “It should be a valuable alternative for ruptured and unruptured wide neck aneurysms, typically requiring balloon assistance for coil embolization, since it provides temporary protection of the parent artery during aneurysm coiling, without arresting flow.”

Wide-neck aneurysms are defined as having a neck greater or equal to four mm or a dome-to-neck ratio of less than two. They are often untreatable by surgical clipping, as many wide- neck aneurysms are in vessels deep within the brain that are not amendable to being treated by open brain surgery. Coiling wide neck aneurysms, on the other hand, could lead to coil protrusion and/or embolization, as it is difficult to achieve and maintain sufficiently dense coil packing of the aneurysm to permanently exclude blood flow.

Related Links:
Rapid Medical
NYU Langone Medical Center