@article {Gory, author = {B. Gory and A. Rouchaud and S. Saleme and F. Dalmay and R. Riva and F. Caire and C. Mounayer}, title = {Endovascular Treatment of Middle Cerebral Artery Aneurysms for 120 Nonselected Patients: A Prospective Cohort Study}, year = {2013}, doi = {10.3174/ajnr.A3781}, publisher = {American Journal of Neuroradiology}, abstract = {BACKGROUND AND PURPOSE: Multiple technologies have developed the endovascular approach to MCA aneurysms. We assess the safety and the efficacy of a systematic endovascular approach in nonselected patients with MCA aneurysms and determine predictors of treatment outcomes. MATERIALS AND METHODS: We analyzed data collected between January 2007 and January 2012 in a prospective clinical registry. All patients with MCA aneurysms treated by means of the endovascular approach were included. A multivariate analysis was conducted to identify predictors of complications, recanalization, and outcome. RESULTS: A total of 120 patients with 131 MCA aneurysms were included. Seventy-nine patients (65.8\%) were treated electively and 41 (34.2\%) in the setting of subarachnoid hemorrhage. Thirty-three of 131 aneurysms (25.2\%) were treated with simple coiling, 79 aneurysms (60.3\%) with balloon-assisted coiling, and 19 aneurysms (14.5\%) with stent-assisted coiling. Complications occurred in 13.7\% of patients. Stent-assisted coiling was significantly associated with more complications (P = .002; OR: 4.86; 95\% CI, 1.60{\textendash}14.72). At 1 month after treatment, both the permanent morbidity (mRS <=2) and mortality rates were 3.3\%, without any significant difference according to the endovascular techniques. Mean angiographic follow-up was 16.3 months. The rate of recanalization was 15.6\% without a statistical difference, according to the technique. Larger aneurysms were a predictor of recanalization (P = .016; OR: 1.183; 95\% CI, 1.02{\textendash}1.36). Retreatment was performed in 10 of 131 aneurysms (7.6\%). CONCLUSIONS: Even though stent-assisted coiling significantly increases the risk of procedural complications, endovascular treatment of MCA aneurysms is safe, effective, and provides durable aneurysm closure in nonselected patients. Abbreviations EVTendovascular treatmentHHHunt and Hess}, issn = {0195-6108}, URL = {https://www.ajnr.org/content/early/2013/11/07/ajnr.A3781}, eprint = {https://www.ajnr.org/content/early/2013/11/07/ajnr.A3781.full.pdf}, journal = {American Journal of Neuroradiology} }