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Safety and Long-Term Efficacy Outcomes for Endovascular Treatment of Wide-Neck Bifurcation Aneurysms of the Middle Cerebral Artery: Insights From the SMART Registry.
De Leacy, Reade; Bageac, Devin V; Siddiqui, Neha; Bellon, Richard J; Park, Min S; Schirmer, Clemens M; Woodward, Keith B; Zaidat, Osama O; Spiotta, Alejandro M.
Afiliación
  • De Leacy R; Department of Neurosurgery, Mount Sinai Hospital, New York, NY, United States.
  • Bageac DV; Department of Neurosurgery, Mount Sinai Hospital, New York, NY, United States.
  • Siddiqui N; Department of Neurosurgery, Mount Sinai Hospital, New York, NY, United States.
  • Bellon RJ; Radiology Imaging Associates PC, Englewood, CO, United States.
  • Park MS; Department of Neurosurgery, University of Virginia, Charlottesville, VA, United States.
  • Schirmer CM; Department of Neurosurgery and Neuroscience Institute, Geisinger Health System, Wilkes-Barre, PA, United States.
  • Woodward KB; Research Institute of Neurointervention, Paracelsus Medical University, Salzburg, Austria.
  • Zaidat OO; Vista Radiology, Knoxville, TN, United States.
  • Spiotta AM; Mercy Health, Toledo, OH, United States.
Front Neurol ; 13: 830296, 2022.
Article en En | MEDLINE | ID: mdl-35197925
INTRODUCTION: Wide-necked middle cerebral artery bifurcation aneurysms pose specific challenges to endovascular management. Surgical clipping remains the standard treatment approach for these aneurysms in many centers. While recent data suggests the endovascular treatment may be comparable, a prospective datapoint has been lacking. MATERIALS AND METHODS: The Penumbra SMART registry, a prospective, multi-center, single-arm outcomes registry of Penumbra coil-treated aneurysms, was queried for endovascularly treated MCA bifurcation aneurysms with wide necks (dome:neck ratio <2 or neck >4 mm). Safety and efficacy outcomes were summarized for ruptured and unruptured aneurysms, including rupture, complication rate, and 1-year occlusion outcomes. RESULTS: Seventy-two aneurysms across 31 sites were enrolled. Of these, a total of 15 presented as ruptured aneurysms. Serious adverse events were reported in 21 (29.2%) of patients, with 8 (11.1%) attributed to the device/procedure. Immediately postoperatively, 75.0% of cases achieved "adequate" Raymond Roy Class I (40.3%) or II (34.7%) occlusion outcomes. Of the 72 patients treated, 60 (83.3%) underwent follow-up angiography at 1 year, and among these, 95.0% had 1-year occlusion outcomes of Raymond Roy Class I (71.7%) or II (23.3%). A total of 6 aneurysms (10.0%) were required or were planned for retreatment at the last follow-up. CONCLUSION: This study represents the most significant prospective sample of endovascularly treated wide-neck MCA bifurcation aneurysms conducted to date. It supports the safety and efficacy of endovascular treatment of these aneurysms.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Idioma: En Revista: Front Neurol Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Clinical_trials Idioma: En Revista: Front Neurol Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Suiza