{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T01:38:05Z","timestamp":1778981885797,"version":"3.51.4"},"reference-count":32,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T00:00:00Z","timestamp":1666137600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2022,10,4]]},"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Endovascular treatment of intracranial wide-necked and bifurcation aneurysms (WNBA) is technically challenging. The Nautilus Intrasaccular System is designed to provide a mechanical barrier at the aneurysm neck to support coil embolization. We report the results of a single-center series of patients treated for intracranial aneurysms with the Nautilus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical and radiological data were retrospectively collected for all patients treated with the Nautilus for an unruptured or ruptured intracranial aneurysm at our center between March 2021 and March 2022. Clinical outcomes (modified Rankin Scale (mRS) scores), Raymond\u2013Roy angiographic occlusion, recanalization, and complications were measured immediately post-procedure and at 3\u20136-month follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 41 patients of mean age 56.7 years (range 37\u201383 years) were treated with the Nautilus, with 41 saccular aneurysms (18 (43.9%) unruptured and 23 (56.1%) ruptured). The majority of aneurysms (39\/41 (95.1%)) were located in the anterior circulation. We experienced no technical complications. One patient had an asymptomatic post-procedural minor stroke related to the procedure. Immediate Class I occlusion was achieved in 30 (73.1%) patients. The rate of all-cause mortality was 7.3% (3\/41). One patient was lost to follow-up. At follow-up, 94.5% (35\/37) of patients achieved Class I occlusion and 94.5% (35\/37) had an mRS score of 0. There were no procedural-related deaths or permanent morbidities at discharge or follow-up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates good safety and effectiveness using the Nautilus Intrasaccular System to treat both ruptured and unruptured intracranial aneurysms. Larger studies are needed to confirm these findings.<\/jats:p><\/jats:sec>","DOI":"10.1136\/jnis-2022-019295","type":"journal-article","created":{"date-parts":[[2022,10,19]],"date-time":"2022-10-19T17:23:04Z","timestamp":1666200184000},"page":"989-994","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Endovascular treatment of wide-necked intracranial aneurysms using the Nautilus Intrasaccular System: initial case series of 41 patients at a single center"],"prefix":"10.1136","volume":"15","author":[{"given":"Alexander","family":"Sirakov","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5514-5237","authenticated-orcid":false,"given":"Pervinder","family":"Bhogal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Sirakova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marin","family":"Penkov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krasimir","family":"Minkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristian","family":"Ninov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hristo","family":"Hristov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asen","family":"Hadzhiyanev","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasil","family":"Karakostov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6034-5340","authenticated-orcid":false,"given":"Stanimir","family":"Sirakov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,10,19]]},"reference":[{"key":"2024052220014468000_15.10.989.1","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1093\/neuros\/nyz017","article-title":"Endosaccular flow disruption: a new frontier in endovascular aneurysm management","volume":"86","author":"Dmytriw","year":"2020","journal-title":"Neurosurgery"},{"key":"2024052220014468000_15.10.989.2","first-page":"1","article-title":"Intrasaccular flow disruption for brain aneurysms: a systematic review of long-term outcomes","author":"Chen","year":"2021","journal-title":"J Neurosurg"},{"key":"2024052220014468000_15.10.989.3","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A4540"},{"key":"2024052220014468000_15.10.989.4","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2015-011682"},{"key":"2024052220014468000_15.10.989.5","doi-asserted-by":"publisher","DOI":"10.1586\/17434440.2014.907741"},{"key":"2024052220014468000_15.10.989.6","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2017-013641"},{"key":"2024052220014468000_15.10.989.7","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A3807"},{"key":"2024052220014468000_15.10.989.8","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1177\/1591019920940521","article-title":"Efficacy and safety of PulseRider for treatment of wide-necked intracranial aneurysm - a systematic review and meta-analysis","volume":"27","author":"Pranata","year":"2021","journal-title":"Interv Neuroradiol"},{"key":"2024052220014468000_15.10.989.9","doi-asserted-by":"crossref","DOI":"10.1016\/j.wneu.2021.04.139","article-title":"Nautilus-assisted coiling of an unruptured wide-necked aneurysm of the posterior communicating artery","volume":"151","author":"Matanov","year":"2021","journal-title":"World Neurosurg"},{"key":"2024052220014468000_15.10.989.10","doi-asserted-by":"publisher","DOI":"10.1136\/neurintsurg-2021-017670"},{"key":"2024052220014468000_15.10.989.11","doi-asserted-by":"crossref","unstructured":"Sirakov A , Mocco J , Sirakov S . Nautilus-assisted coil occlusion for treatment of a ruptured aneurysm at the bifurcation of the right middle cerebral artery: complete occlusion achieved in one session with a good clinical outcome. In: Henkes H , Lylyk P , Ganslandt O , eds. The aneurysm casebook. 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