PT  - JOURNAL ARTICLE
AU  - Pierot, L.
AU  - Cognard, C.
AU  - Anxionnat, R.
AU  - Ricolfi, F.
TI  - Endovascular Treatment of Ruptured Intracranial Aneurysms: Factors Affecting Midterm Quality Anatomic Results: Analysis in a Prospective, Multicenter Series of Patients (CLARITY)
AID  - 10.3174/ajnr.A3003
DP  - 2012 Sep 01
TA  - American Journal of Neuroradiology
PG  - 1475--1480
VI  - 33
IP  - 8
4099  - http://www.ajnr.org/content/33/8/1475.short
4100  - http://www.ajnr.org/content/33/8/1475.full
SO  - Am. J. Neuroradiol.2012 Sep 01; 33
AB  - 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. ACAanterior cerebral arteryAcomAanterior communicating arteryCLARITYCLinical and Anatomical Results In the Treatment of ruptured intracranial aneurYsmsEVTendovascular treatmentGDCGuglielmi detachable coilVBvertebrabasilar systemWFNSWorld Federation of Neurological Surgeons