Immediate clinical outcome of patients harboring unruptured intracranial aneurysms treated by endovascular approach: results of the ATENA study.
OBJECTIVE
The management of unruptured intracranial aneurysms remains controversial and the results of endovascular treatment are not precisely known because no prospective data exist. The first prospective multicenter study (ATENA) was conducted in Canada and France to determine clinical outcome and risks of this treatment.


METHODS
Six hundred forty-nine patients harboring a total of 1100 aneurysms from 27 Canadian and French neurointerventional centers were prospectively and consecutively treated by endovascular coil embolization. Of these, 739 unruptured intracranial aneurysms were treated during 700 procedures. Aneurysms were selectively treated in the great majority of cases (98.4%) with coils alone (54.5%), the balloon remodeling technique (37.3%), or stenting (7.8%).


RESULTS
Endovascular treatment failed in 32 aneurysms (4.3%). Technical adverse events with or without clinical modification were encountered in 15.4% of patients and included thromboembolic complications (7.1% per procedure), intraoperative rupture (2.6% per procedure), and device-related problems (2.9% per procedure). Adverse events associated with transient or permanent neurological deficit or death were encountered in 5.4% of cases. The 1-month morbidity and mortality rates were 1.7% and 1.4%, respectively.


CONCLUSIONS
Endovascular treatment of unruptured intracranial aneurysms is feasible in a high percentage of cases with low morbidity and mortality rates.
Pierot
Laurent
L
Service de Radiologie, Hôpital Maison-Blanche, 45, rue Cognacq-Jay, 51092 Reims cedex, France. lpierot@chu-reims.fr
Spelle
Laurent
L
Vitry
Fabien
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D002536:Cerebral Arteries / Q000473:pathology* / Q000503:physiopathology; D004621:Embolization, Therapeutic / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D019736:Prostheses and Implants / Q000009:adverse effects / Q000706:statistics & numerical data; D015607:Stents / Q000009:adverse effects / Q000706:statistics & numerical data; D013345:Subarachnoid Hemorrhage / Q000517:prevention & control; D013923:Thromboembolism / Q000453:epidemiology; D016896:Treatment Outcome