The EP-VRD2 for endovascular treatment of ophthalmic segment aneurysms: wall apposition and long-term study

Objectives The Enterprise Vascular Reconstruction Devices 2 (EP-VRD2) are designed to improve apposition to curved vessel walls. This study aimed to evaluate the wall apposition (WA) and long-term safety and effectiveness of EP-VRD2 for treating ophthalmic segment aneurysms (OSAs). Materials and methods Dyna CT angiography (CTA) was used to evaluate WA, while digital subtraction angiography (DSA) and the modified Rankin score (mRS) were utilized for imaging and outcome follow-up, respectively. The minimum follow-up was 12 months. Results A total of 104 OSAs treated with EP-VRD2 were collected. The complication rate was 3.84%, all due to thromboembolic events. Immediate angiography revealed Raymond–Roy occlusion classification (RROC) I in 73.08% of cases, II in 23.08%, and III in 3.84%. DSA follow-up of 90 OSAs over an average of 19.91 ± 7.16 months showed a complete occlusion rate of 95.56%. Clinical follow-up averaged 22.15 ± 9.26 months, with mRS ranging from 0 to 2. Crescent signs, indicating incomplete stent apposition (ISA), were observed in 11.54% of cases. Curvature radius (CR) and artery angle (AA) were significantly different between the complete apposition and ISA groups, with cut-off values identified at 44° and 3.58 mm. Conclusion EP-VRD2 stents are safe and effective for long-term treatment of OSAs, significantly improving WA in curved vessels. However, ISA remains in sharp ICA siphon bends, particularly with an AA < 44° or CR < 3.58 mm.