title: Endovascular treatment of ruptured intracranial aneurysms: factors affecting midterm quality anatomic results: analysis in a prospective, multicenter series of patients (CLARITY).
abstract: OBJECTIVE
  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.
  
  
  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 = .005), and ICA location (P = .049). 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 < .001). In univariate analysis, the evolution of aneurysm occlusion was affected by age (P = .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.
authors.affiliation: Department of Neuroradiology, Reims University, Reims, France. lpierot@gmail.com
authors.forename: L
authors.initials: L
authors.lastname: Pierot
authors.forename: C
authors.initials: C
authors.lastname: Cognard
authors.forename: R
authors.initials: R
authors.lastname: Anxionnat
authors.forename: F
authors.initials: F
authors.lastname: Ricolfi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000628:therapy*; D004621:Embolization, Therapeutic; D057510:Endovascular Procedures; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015607:Stents; D055815:Young Adult