Current evidence on novel devices for the treatment of intracranial wide-neck aneurysms—Contour and Neqstent: a narrative review

Background and Objective: Intrasaccular devices have been adapting and evolving to improve the management of wide-neck intracranial aneurysms (IAs), with the aim of improving occlusion rates, decreasing the need for antiplatelet therapy post treatment, and becoming less invasive and complex in their design and deployment. By occupying the aneurysm neck alone, and avoiding deployment via the parental artery, new devices such as Contour and Neqstent aim to achieve this. This review aims to discuss the origin of intrasaccular devices, the evolution of the design and deployment, and the available evidence of Contour and Neqstent, which could increase the range of complex wide-neck aneurysms that can be treated with an intra-saccular solution. Methods: A literature search was completed on widely available intrasaccular devices for the treatment of IAs, with a particular focus on efficacy and safety results of Contour and Neqstent. Key Content and Findings: The reviewed published data demonstrates a safe profile of Contour and Neqstent treatment of wide-neck aneurysms. The short- and medium-term efficacy of the devices is comparable with other available intrasaccular solutions, therefore offering a wider range of possible treatment options, particularly irregular complex aneurysms. Conclusions: The authors recommend the routine use of short-term antiplatelet therapy for these devices.