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AJNR - American Journal of Neuroradiology

Published ahead of print on September 3, 2009
doi: 10.3174/ajnr.A1745

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American Journal of Neuroradiology 31:140-144, January 2010
© 2010 American Society of Neuroradiology

INTERVENTIONAL

Immediate Anatomic Results after the Endovascular Treatment of Unruptured Intracranial Aneurysms: Analysis of the ATENA Series

L. Pierot^a, L. Spelle^c, F. Vitry^b and ATENA investigators

^aFrom the Department of Neuroradiology (L.P.), Maison Blanche Hospital
^bDepartment of Clinical Research (F.V.), CHU Reims, Reims, France
^cDepartment of Neuroradiology, Fondation Rothschild Hospital, Paris, France (L.S.).

Please address correspondence to Professeur Laurent Pierot, Service de Radiologie, Hôpital Maison-Blanche, 45 rue Cognacq-Jay, 51092 Reims, Cedex, France; e-mail: lpierot{at}gmail.com

BACKGROUND AND PURPOSE: A precise analysis of the immediate postoperative anatomic results in a large series of unruptured intracranial aneurysms treated by endovascular approach has not previously been presented. This study aimed to assess the efficacy of endovascular treatment of unruptured intracranial aneurysms in light of immediate postoperative anatomic results in a prospective, multicenter study (the Analysis of Treatment by Endovascular Approach of Nonruptured Aneurysms study; ATENA).

MATERIALS AND METHODS: Postoperative anatomic results from digital subtraction angiography (DSA) were evaluated with the Montreal scale by the treating physician and by 2 anonymous, independent, experienced neuroradiologists.

RESULTS: The analysis included 622 patients (449 women, 173 men; age range, 22–83 years; mean age, 51.2 ± 11.3 years) harboring 694 aneurysms. Evaluation of the postoperative anatomic results by the 2 independent reviewers indicated total occlusions in 437 aneurysms (63.0%), neck remnants in 156 aneurysms (22.5%), and aneurysm remnants in 101 aneurysms (14.6%). Several factors favorably affected the quality of the aneurysm occlusion with treatment, including patient age (< 65 years old; P < .0001), aneurysm diameter ( 6 mm; P = .0049), aneurysm dome-to-neck ratio (> 1.5; P = .0388), and endovascular technique (coiling or remodelling compared with stent placement; P = .0001).

CONCLUSIONS: The endovascular treatment of unruptured aneurysms provided satisfactory postoperative occlusion rates, with a high percentage of complete occlusion or neck remnants (85.4%). Postoperative anatomic results were significantly affected by aneurysm size and neck size, but not aneurysm location.

This article has been cited by other articles:

				L. Pierot, C. Cognard, F. Ricolfi, R. Anxionnat, and for the CLARITY Investigators Immediate Anatomic Results after the Endovascular Treatment of Ruptured Intracranial Aneurysms: Analysis in the CLARITY Series AJNR Am. J. Neuroradiol., May 1, 2010; 31(5): 907 - 911. [Abstract] [Full Text] [PDF]