BACKGROUND AND PURPOSE: Recanalization is 1 drawback of the EVT of intracranial aneurysms. An analysis of the factors affecting the midterm anatomic results after EVT of ruptured intracranial aneurysms in a large multicenter series (CLARITY) is presented. MATERIALS AND METHODS: Of the 782 patients initially included in the CLARITY trial, 649 would theoretically undergo midterm follow-up examinations. Finally, 517/649 (79.7%) completed a midterm follow-up examination. Midterm anatomic results were independently and anonymously evaluated by 2 experienced neuroradiologists. RESULTS: In univariate analysis, factors affecting the quality of midterm occlusion were the quality of the postoperative occlusion (P < .001), hypertension (P = .018), aneurysm size (P = .007), neck size (P = .005), and ICA location (P = .049). In multivariate analysis, 3 factors were associated with the quality of postoperative aneurysm occlusion: neck size (P = .003), use of the balloon remodeling technique (P = .031), and the quality of postoperative occlusion (P < .001). In univariate analysis, the evolution of aneurysm occlusion was affected by age (P = .024) and neck size (P = .041). In multivariate analysis, it was associated with the same factors: age (P = .025) and neck size (P = .043). CONCLUSIONS: Among the many factors considered in this analysis, aneurysm neck size was identified as the single most important one in the quality of aneurysm occlusion at midterm follow-up after EVT. The present results suggest developing and evaluating new strategies of treatment and technique, especially for wide-neck aneurysms, with a focus on reinforcement and neoendothelialization at the level of the neck as objectives.
BACKGROUND AND PURPOSE: Recanalization is 1 drawback of the EVT of intracranial aneurysms. An analysis of the factors affecting the midterm anatomic results after EVT of ruptured intracranial aneurysms in a large multicenter series (CLARITY) is presented. MATERIALS AND METHODS: Of the 782 patients initially included in the CLARITY trial, 649 would theoretically undergo midterm follow-up examinations. Finally, 517/649 (79.7%) completed a midterm follow-up examination. Midterm anatomic results were independently and anonymously evaluated by 2 experienced neuroradiologists. RESULTS: In univariate analysis, factors affecting the quality of midterm occlusion were the quality of the postoperative occlusion (P < .001), hypertension (P = .018), aneurysm size (P = .007), neck size (P = .005), and ICA location (P = .049). In multivariate analysis, 3 factors were associated with the quality of postoperative aneurysm occlusion: neck size (P = .003), use of the balloon remodeling technique (P = .031), and the quality of postoperative occlusion (P < .001). In univariate analysis, the evolution of aneurysm occlusion was affected by age (P = .024) and neck size (P = .041). In multivariate analysis, it was associated with the same factors: age (P = .025) and neck size (P = .043). CONCLUSIONS: Among the many factors considered in this analysis, aneurysm neck size was identified as the single most important one in the quality of aneurysm occlusion at midterm follow-up after EVT. The present results suggest developing and evaluating new strategies of treatment and technique, especially for wide-neck aneurysms, with a focus on reinforcement and neoendothelialization at the level of the neck as objectives.
Authors: Sandra P Ferns; Marieke E S Sprengers; Willem Jan van Rooij; Gabriël J E Rinkel; Jeroen C van Rijn; Shandra Bipat; Menno Sluzewski; Charles B L M Majoie Journal: Stroke Date: 2009-06-11 Impact factor: 7.914
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: G Foa Torres; F Roca; A Noguera; J Godes; S Petrocelli; I Aznar; S Ales; P Muszynski; R Maehara; M Vicente; J M Pumar Journal: Interv Neuroradiol Date: 2018-05-02 Impact factor: 1.610
Authors: L Pierot; J Klisch; T Liebig; J-Y Gauvrit; M Leonardi; N P Nuzzi; F Di Paola; V Sychra; B Mine; B Lubicz Journal: AJNR Am J Neuroradiol Date: 2015-07-30 Impact factor: 3.825
Authors: W Brinjikji; P M White; H Nahser; J Wardlaw; R Sellar; A Gholkar; H J Cloft; D F Kallmes Journal: AJNR Am J Neuroradiol Date: 2015-07-30 Impact factor: 3.825