BACKGROUND: The International Subarachnoid Aneurysm Trial (ISAT) showed that for ruptured aneurysms suitable for both techniques, coiling should be the first-choice treatment. Only a small proportion of patients (22%) with ruptured aneurysms were included in that trial. Operators were selected on their experience. One could then criticize the impact of the ISAT on clinical practice as a result of recruitment biases and operators' selection. OBJECTIVE: To evaluate the morbidity and mortality of coiling when used as first-choice treatment in a consecutive population of patients with ruptured aneurysms treated by nonselected operators. METHODS: Thirty-four operators from 19 French centers treated 405 patients with GDC coils from November 2006 to July 2007. The method of treatment was not prespecified. RESULTS: World Federation of Neurological Societies grade at admission was I/II in 65.7% and IV/V in 30.6% of patients. At the 3- to 6-month follow-up, 23.3% of patients were dependent or dead. Thromboembolic events and intraoperative rupture resulted in permanent deficit in 13 (3.2%) and 2 (0.5%), respectively, and death in 4 (1.0%) and 0. Early rebleeding occurred in 2 patients (0.5%) with 2 subsequent deaths. Permanent treatment morbidity and mortality were 3.7 % and 1.5 %, respectively. CONCLUSION: Clinical results of the multicenter prospective Clarity registry show that when coiling is performed as first-intention treatment in a consecutive series of nonselected ruptured aneurysms by nonselected operators, clinical results are similar to those of the ISAT.
BACKGROUND: The International Subarachnoid Aneurysm Trial (ISAT) showed that for ruptured aneurysms suitable for both techniques, coiling should be the first-choice treatment. Only a small proportion of patients (22%) with ruptured aneurysms were included in that trial. Operators were selected on their experience. One could then criticize the impact of the ISAT on clinical practice as a result of recruitment biases and operators' selection. OBJECTIVE: To evaluate the morbidity and mortality of coiling when used as first-choice treatment in a consecutive population of patients with ruptured aneurysms treated by nonselected operators. METHODS: Thirty-four operators from 19 French centers treated 405 patients with GDC coils from November 2006 to July 2007. The method of treatment was not prespecified. RESULTS: World Federation of Neurological Societies grade at admission was I/II in 65.7% and IV/V in 30.6% of patients. At the 3- to 6-month follow-up, 23.3% of patients were dependent or dead. Thromboembolic events and intraoperative rupture resulted in permanent deficit in 13 (3.2%) and 2 (0.5%), respectively, and death in 4 (1.0%) and 0. Early rebleeding occurred in 2 patients (0.5%) with 2 subsequent deaths. Permanent treatment morbidity and mortality were 3.7 % and 1.5 %, respectively. CONCLUSION: Clinical results of the multicenter prospective Clarity registry show that when coiling is performed as first-intention treatment in a consecutive series of nonselected ruptured aneurysms by nonselected operators, clinical results are similar to those of the ISAT.
Authors: Eduardo Murias Quintana; Pedro Vega Valdes; Edison Morales Deza; Alberto Gil García; María Cadenas Rodríguez; Jose María Jiménez Pérez; Juan Chaviano; Julio Cesar Gutierrez Morales; Kelvin Piña Batista; Faustino Arias García Journal: Interv Neuroradiol Date: 2019-04-02 Impact factor: 1.610
Authors: B Lubicz; J Klisch; J-Y Gauvrit; I Szikora; M Leonardi; T Liebig; N P Nuzzi; E Boccardi; F D Paola; M Holtmannspötter; W Weber; E Calgliari; V Sychra; B Mine; L Pierot Journal: AJNR Am J Neuroradiol Date: 2014-01-23 Impact factor: 3.825
Authors: C Papagiannaki; L Spelle; A-C Januel; A Benaissa; J-Y Gauvrit; V Costalat; H Desal; F Turjman; S Velasco; X Barreau; P Courtheoux; C Cognard; D Herbreteau; J Moret; L Pierot Journal: AJNR Am J Neuroradiol Date: 2014-07-03 Impact factor: 3.825
Authors: L Pierot; J Moret; F Turjman; D Herbreteau; H Raoult; X Barreau; S Velasco; H Desal; A-C Januel; P Courtheoux; J-Y Gauvrit; C Cognard; A Molyneux; J Byrne; L Spelle Journal: AJNR Am J Neuroradiol Date: 2015-10-29 Impact factor: 3.825