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Research ArticleNeurointervention
Open Access

Aneurysm Characteristics, Study Population, and Endovascular Techniques for the Treatment of Intracranial Aneurysms in a Large, Prospective, Multicenter Cohort: Results of the Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm Study

M. Gawlitza, S. Soize, C. Barbe, A. le Clainche, P. White, L. Spelle and L. Pierot ARETA Study Group
American Journal of Neuroradiology March 2019, 40 (3) 517-523; DOI: https://doi.org/10.3174/ajnr.A5991
M. Gawlitza
aFrom the Department of Neuroradiology (M.G., S.S., L.P.), Hôpital Maison-Blanche, Centre Hospitalier Universitaire Reims, Reims, France
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  • ORCID record for M. Gawlitza
S. Soize
aFrom the Department of Neuroradiology (M.G., S.S., L.P.), Hôpital Maison-Blanche, Centre Hospitalier Universitaire Reims, Reims, France
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C. Barbe
bDepartment of Research and Public Health (C.B., A.l.C.), Hôpital Robert Debré, Centre Hospitalier Universitaire Reims, Reims, France
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A. le Clainche
bDepartment of Research and Public Health (C.B., A.l.C.), Hôpital Robert Debré, Centre Hospitalier Universitaire Reims, Reims, France
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P. White
cDepartment of Neuroradiology (P.W.), Royal Victoria Infirmary, Newcastle upon Tyne, UK
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L. Spelle
dInterventional Neuroradiology (L.S.), NEURI Center, Hopital Bicêtre, Le Kremlin-Bicêtre, France.
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L. Pierot
aFrom the Department of Neuroradiology (M.G., S.S., L.P.), Hôpital Maison-Blanche, Centre Hospitalier Universitaire Reims, Reims, France
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    FIGURE

    Flow chart of the study population. “Treatment failure” refers to an endovascular treatment attempt that was aborted before a device was implanted.

Tables

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    Table 1:

    Demographic characteristics of 1289 patients

    Variables
    Female (No.) (%)866 (67.2%)
    Age (mean)54.1 ± 12.7 years
    Single IA (No.) (%)970 (75.3%)
    Multiple IAs (No.) (%)319 (24.7%)
        2 IAs (No.) (%)214 (67.1%)
        3 IAs (No.) (%)73 (22.9%)
        4 IAs (No.) (%)23 (7.2%)
        5 IAs (No.) (%)5 (1.6%)
        6 IAs (No.) (%)2 (0.6%)
        7 IAs (No.) (%)1 (0.3%)
        8 IAs (No.) (%)1 (0.3%)
    Tobacco (No.) (%)a768 (60.4%)
        Active smoking (No.) (%)b559/762 (73.4%)
        Pack-years (mean)c26.0 ± 21.0
    Regular alcohol consumption (No.) (%)d255 (20.2%)
    Cannabis use (No.) (%)e45 (3.6%)
    Other recreational drugs (No.) (%)d15 (1.2%)
    Hypertension (No.) (%)f462 (36.1%)
        With treatment (No.) (%)g363/449 (80.9%)
        Normalized blood pressure (No.) (%)h304/429 (70.9%)
    Dyslipidemia (No.) (%)i226 (17.8%)
        Hypercholesterolemia (No.) (%)j195/207 (94.2%)
        Hypertriglyceridemia (No.) (%)k47/198 (23.7%)
        With treatment (No.) (%)l151/206 (73.3%)
    Family history of IA (No.) (%)m90 (7.2%)
    Diabetes mellitus (No.) (%)f63 (4.9%)
        Dietary treatment onlyn17/60 (28.3%)
        Oral antidiabetic treatmento40/62 (64.5%)
        Insulin treatmentp9/61 (14.8%)
    Polycystic kidney disease (No.) (%)q17 (1.3%)
    Connective tissue disease (No.) (%)f1 (0.1%)
    • ↵a The following are missing data: 17 (1.3%).

    • ↵b 6 (0.8%).

    • ↵c 120 (15.6%).

    • ↵d 24 (1.9%).

    • ↵e 22 (1.7%).

    • ↵f 9 (0.7%).

    • ↵g 13 (2.8%).

    • ↵h 33 (7.1%).

    • ↵i 16 (1.2%).

    • ↵j 19 (8.4%).

    • ↵k 28 (12.4%).

    • ↵l 20 (8.8%).

    • ↵m 30 (2.3%).

    • ↵n 3 (4.8%).

    • ↵o 1 (1.6%).

    • ↵p 2 (3.2%).

    • ↵q 8 (0.6%).

    • View popup
    Table 2:

    All aneurysms in the study collective and treated aneurysms

    LocationAll AneurysmsaTreated Aneurysms
    No.%No.%
    ACA/AcomA55731.749736.6
    MCA45826.028320.8
    Intradural ICA53030.143832.2
    Extradural ICA885.0372.7
    Vertebrobasilar1267.21047.6
    Total17511001359100
    • Note:—ACA indicates anterior cerebral artery; AcomA, anterior communicating artery.

    • ↵a Two missing data.

    • View popup
    Table 3:

    Techniques used for embolization of ruptured and unruptured aneurysms

    Treatment ModalityAll IAsRIAsUIAsP Value
    No.%No.%No.%
    Coiling alone65047.846155.218936.1<0.001
    Balloon-assisted coiling55240.635642.619637.4.06
    Stent-assisted coiling493.681.0417.8<0.001
    Flow diversiona654.840.56111.6<0.001
    Flow disruptionb413.050.6366.9<0.001
    Parent vessel occlusion20.210.110.2.74
    Total1359100835100524100
    • ↵a Thirty aneurysms were treated in conjunction with coils.

    • ↵b Two aneurysms were treated in conjunction with coils; 3 aneurysms, in conjunction with a remodeling balloon; and 1 aneurysm, with an ancillary stent.

    • View popup
    Table 4:

    Treatment modality with regard to aneurysm sac diameter

    Treatment ModalityAll IAs<10 mm10–25 mm>25 mmP Value
    No.%No.%No.%No.%
    Coiling alone65047.856949.58139.300.003
    Balloon-assisted coiling55240.647241.18038.800.24
    Stent-assisted coiling493.6373.2125.800.20
    Flow diversion654.8353.12713.1375.0<0.001
    Flow disruption413.0353.162.900.93
    Parent vessel occlusion20.210.100125.0.006
    Total135910011491002061004100
    • View popup
    Table 5:

    Treatment modality with regard to aneurysm neck diameter

    Treatment ModalityAll IAs<4 mm≥4 mmP Value
    No.%No.%No.%
    Coiling alone65047.851155.213932.0<0.001
    Balloon-assisted coiling55240.637540.517740.8.93
    Stent-assisted coiling493.6171.8327.4<0.001
    Flow diversion654.8171.84811.1<0.001
    Flow disruption413.050.5368.3<0.001
    Parent vessel occlusion20.20020.5.10
    Total1359100925100434100
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American Journal of Neuroradiology: 40 (3)
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Cite this article
M. Gawlitza, S. Soize, C. Barbe, A. le Clainche, P. White, L. Spelle, L. Pierot
Aneurysm Characteristics, Study Population, and Endovascular Techniques for the Treatment of Intracranial Aneurysms in a Large, Prospective, Multicenter Cohort: Results of the Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm Study
American Journal of Neuroradiology Mar 2019, 40 (3) 517-523; DOI: 10.3174/ajnr.A5991

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Aneurysm Characteristics, Study Population, and Endovascular Techniques for the Treatment of Intracranial Aneurysms in a Large, Prospective, Multicenter Cohort: Results of the Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm Study
M. Gawlitza, S. Soize, C. Barbe, A. le Clainche, P. White, L. Spelle, L. Pierot
American Journal of Neuroradiology Mar 2019, 40 (3) 517-523; DOI: 10.3174/ajnr.A5991
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