RT Journal Article
SR Electronic
T1 Immediate Anatomic Results after the Endovascular Treatment of Ruptured Intracranial Aneurysms: Analysis in the CLARITY Series
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 907
OP 911
DO 10.3174/ajnr.A1954
VO 31
IS 5
A1 L. Pierot
A1 C. Cognard
A1 F. Ricolfi
A1 R. Anxionnat
A1 for the CLARITY Investigators
YR 2010
UL http://www.ajnr.org/content/31/5/907.abstract
AB 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. ACAanterior cerebral arteryAcomAanterior communicating arteryATENAAnalysis of Treatment by Endovascular Approach of Nonruptured AneurysmsCARATCerebral Aneurysm Rerupture After TreatmentCLARITYClinical and Anatomical Results in the Treatment of Ruptured Intracranial AneurysmsCHCentre HospitalierCHUCentre Hospitalier UniversitaireDSAdigital subtraction angiographyGDCGuglielmi detachable coilsICAinternal carotid arteryISATInternational Subarachnoid Aneurysm TrialMCAmiddle cerebral arteryVBvertebrobasilar system