Endovascular Treatment of Ruptured Intracranial Aneurysms: Factors Affecting Midterm Quality Anatomic Results: Analysis in a Prospective, Multicenter Series of Patients (CLARITY)

被引:71
作者
Pierot, L. [1 ]
Cognard, C. [2 ]
Anxionnat, R. [3 ]
Ricolfi, F. [4 ]
机构
[1] Univ Reims, Dept Neuroradiol, Reims, France
[2] Toulouse Univ, Dept Neuroradiol, Toulouse, France
[3] Nancy Univ, Dept Neuroradiol, Nancy, France
[4] Univ Dijon, Dept Radiol, F-21004 Dijon, France
关键词
ANGIOGRAPHIC FOLLOW-UP; OCCLUSION; COILS;
D O I
10.3174/ajnr.A3003
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
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 = .0051, and ICA location (P = .0491. 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 < .0011. In univariate analysis, the evolution of aneurysm occlusion was affected by age IP = .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.
引用
收藏
页码:1475 / 1480
页数:6
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