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Immediate Anatomic Results after the Endovascular Treatment of Ruptured Intracranial Aneurysms: Analysis in the CLARITY Series

Immediate Anatomic Results after the Endovascular Treatment of Ruptured Intracranial Aneurysms:... This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1954v1 31/5/907 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Pierot, L. PubMed PubMed Citation Articles by Pierot, L. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:907-911, May 2010 © 2010 American Society of Neuroradiology INTERVENTIONAL Immediate Anatomic Results after the Endovascular Treatment of Ruptured Intracranial Aneurysms: Analysis in the CLARITY Series L. Pierot a , C. Cognard b , F. Ricolfi c , R. Anxionnat d and for the CLARITY Investigators a Department of Neuroradiology (L.P.), Maison Blanche Hospital, CHU Reims, Reims, France b Department of Neuroradiology (C.C), CHU Toulouse, Toulouse, France c Department of Neuroradiology (F.R.), CHU Dijon, Dijon, France d Department of Neuroradiology (R.A.), CHU Nancy, Nancy, France. Please address correspondence to Laurent Pierot, MD, Service de Radiologie, Hôpital Maison-Blanche, 45 rue Cognacq-Jay 51092 REIMS cedex, France; e-mail: lpierot@gmail.com BACKGROUND AND PURPOSE: The efficacy of the endovascular treatment in providing stable occlusion of intracranial aneurysms is still controversial and should be precisely analyzed. A first step is to carefully study immediate anatomical results. CLARITY (Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms) is a prospective multicenter consecutive series including patients treated by coiling for ruptured aneurysms. Immediate anatomic results are presented. MATERIALS AND METHODS: Postoperative anatomic results were evaluated by DSA by the treating physician and anonymously and independently by 2 experienced neuroradiologists by using the 3-point Montreal Scale. Patients were divided into 2 groups: patients treated with GDC and those treated with Matrix detachable coils. RESULTS: A total of 773 patients (461 women, 312 men; 19–80 years of age; mean, 51.2 ± 13.2 years) with 773 ruptured aneurysms were included in the study. The rate of occlusion as determined by the treating physician was designated complete for 586 aneurysms (75.8%), neck remnant for 145 aneurysms (18.8%), and aneurysm remnant for 42 aneurysms (5.4%). The same evaluation as reported by the 2 independent reviewers was complete occlusion for 366 aneurysms (47.4%), neck remnant for 324 aneurysms (41.9%), and aneurysm remnant for 83 aneurysms (10.7%). Postoperative anatomic results were significantly linked to age but not to the technique of endovascular treatment or aneurysm characteristics (location, size, dome-to neck ratio). Results were not significantly different between the GDC and Matrix group. CONCLUSIONS: Endovascular treatment of ruptured intracranial aneurysms resulted in a high rate of satisfactory occlusion (complete occlusion and neck remnant in 89.3%). Patient age was the only factor associated with the rate of occlusion. The rate of aneurysm occlusion differed insignificantly between GDC and Matrix coils. Abbreviations: ACA, anterior cerebral artery • AcomA, anterior communicating artery • ATENA, Analysis of Treatment by Endovascular Approach of Nonruptured Aneurysms • CARAT, Cerebral Aneurysm Rerupture After Treatment • CLARITY, Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms • CH, Centre Hospitalier • CHU, Centre Hospitalier Universitaire • DSA, digital subtraction angiography • GDC, Guglielmi detachable coils • ICA, internal carotid artery • ISAT, International Subarachnoid Aneurysm Trial • MCA, middle cerebral artery • VB, vertebrobasilar system Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Neuroradiology American Journal of Neuroradiology

Immediate Anatomic Results after the Endovascular Treatment of Ruptured Intracranial Aneurysms: Analysis in the CLARITY Series

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Publisher
American Journal of Neuroradiology
Copyright
Copyright © 2010 by the American Society of Neuroradiology.
ISSN
0195-6108
eISSN
1936-959X
DOI
10.3174/ajnr.A1954
Publisher site
See Article on Publisher Site

Abstract

This Article Free to Access Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1954v1 31/5/907 most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Google Scholar Articles by Pierot, L. PubMed PubMed Citation Articles by Pierot, L. Hotlight (NEW!) What's Hotlight? American Journal of Neuroradiology 31:907-911, May 2010 © 2010 American Society of Neuroradiology INTERVENTIONAL Immediate Anatomic Results after the Endovascular Treatment of Ruptured Intracranial Aneurysms: Analysis in the CLARITY Series L. Pierot a , C. Cognard b , F. Ricolfi c , R. Anxionnat d and for the CLARITY Investigators a Department of Neuroradiology (L.P.), Maison Blanche Hospital, CHU Reims, Reims, France b Department of Neuroradiology (C.C), CHU Toulouse, Toulouse, France c Department of Neuroradiology (F.R.), CHU Dijon, Dijon, France d Department of Neuroradiology (R.A.), CHU Nancy, Nancy, France. Please address correspondence to Laurent Pierot, MD, Service de Radiologie, Hôpital Maison-Blanche, 45 rue Cognacq-Jay 51092 REIMS cedex, France; e-mail: lpierot@gmail.com BACKGROUND AND PURPOSE: The efficacy of the endovascular treatment in providing stable occlusion of intracranial aneurysms is still controversial and should be precisely analyzed. A first step is to carefully study immediate anatomical results. CLARITY (Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms) is a prospective multicenter consecutive series including patients treated by coiling for ruptured aneurysms. Immediate anatomic results are presented. MATERIALS AND METHODS: Postoperative anatomic results were evaluated by DSA by the treating physician and anonymously and independently by 2 experienced neuroradiologists by using the 3-point Montreal Scale. Patients were divided into 2 groups: patients treated with GDC and those treated with Matrix detachable coils. RESULTS: A total of 773 patients (461 women, 312 men; 19–80 years of age; mean, 51.2 ± 13.2 years) with 773 ruptured aneurysms were included in the study. The rate of occlusion as determined by the treating physician was designated complete for 586 aneurysms (75.8%), neck remnant for 145 aneurysms (18.8%), and aneurysm remnant for 42 aneurysms (5.4%). The same evaluation as reported by the 2 independent reviewers was complete occlusion for 366 aneurysms (47.4%), neck remnant for 324 aneurysms (41.9%), and aneurysm remnant for 83 aneurysms (10.7%). Postoperative anatomic results were significantly linked to age but not to the technique of endovascular treatment or aneurysm characteristics (location, size, dome-to neck ratio). Results were not significantly different between the GDC and Matrix group. CONCLUSIONS: Endovascular treatment of ruptured intracranial aneurysms resulted in a high rate of satisfactory occlusion (complete occlusion and neck remnant in 89.3%). Patient age was the only factor associated with the rate of occlusion. The rate of aneurysm occlusion differed insignificantly between GDC and Matrix coils. Abbreviations: ACA, anterior cerebral artery • AcomA, anterior communicating artery • ATENA, Analysis of Treatment by Endovascular Approach of Nonruptured Aneurysms • CARAT, Cerebral Aneurysm Rerupture After Treatment • CLARITY, Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms • CH, Centre Hospitalier • CHU, Centre Hospitalier Universitaire • DSA, digital subtraction angiography • GDC, Guglielmi detachable coils • ICA, internal carotid artery • ISAT, International Subarachnoid Aneurysm Trial • MCA, middle cerebral artery • VB, vertebrobasilar system Home Subscribe Author Instructions Submit Online Search the AJNR Archives Feedback Help Copyright © 2010 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X

Journal

American Journal of NeuroradiologyAmerican Journal of Neuroradiology

Published: May 1, 2010

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