Aneurysm Characteristics, Study Population, and Endovascular Techniques for the Treatment of Intracranial Aneurysms in a Large, Prospective, Multicenter Cohort: Results of the Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm Study

Abstract

BACKGROUND AND PURPOSE:The Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm (ARETA) prospective study aims to determine factors predicting recurrence after endovascular treatment for intracranial aneurysms. In this publication, we review endovascular techniques and present the study population. Characteristics of treated and untreated unruptured aneurysms were analyzed. MATERIALS AND METHODS:Sixteen neurointerventional departments prospectively enrolled patients treated for ruptured and unruptured intracranial aneurysms between December 2013 and May 2015. Patient demographics, aneurysm characteristics, and endovascular techniques were recorded. RESULTS:A total of 1289 patients with 1761 intracranial aneurysms, 835 (47.4%) ruptured, were enrolled. Of these, 1359 intracranial aneurysms were treated by endovascular means. Ruptured intracranial aneurysms were treated by coiling and balloon-assisted coiling in 97.8% of cases. In unruptured intracranial aneurysms, the rates of flow diversion, flow disruption, and stent-assisted coiling were 11.6%, 6.9%, and 7.8%, respectively. Rupture status and aneurysm location, neck diameter, and sac size significantly influenced the chosen technique. Treated unruptured intracranial aneurysms, compared with untreated counterparts, had larger aneurysm sacs (7.6 Ϯ 4.0 versus 3.4 Ϯ 2.0 mm; P Ͻ 0.001) and neck dimensions (4.1 Ϯ 2.2 versus 2.4 Ϯ 1.3 mm; P Ͻ 0.001) and more frequently an irregular form (84.6% versus 44.4%; P Ͻ 0.001). Also, its location influenced whether an unruptured intracranial aneurysm was treated.

Effects of Carbon Nanotube Infiltration on a Shape Memory Polymer‐Based Device for Brain Aneurysm Therapeutics: Design and Characterization of a Joule‐Heating Triggering Mechanism

“…First, we designed an idealized aneurysm model that simulated a saccular aneurysm with anatomically relevant dimensions. Specifically, the model included a Y‐shaped vessel bifurcation of 3 mm in diameter, to mimic the average intracranial vessel dimensions, [ 58,59 ] and a spherical chamber of 7.5 mm in diameter, representing a medium‐sized saccular aneurysm, [ 6,60 ] located at the bifurcation point of the vessel ( Figure a). Then, a CNT‐infiltrated SMP foam, that was manually trimmed to fit the spherical aneurysm chamber, was heated above its (39 °C), compressed uniaxially and transported to the saccular space of the aneurysm model.…”

“…[ 1,5 ] In general, unruptured brain aneurysms will grow over time and may ultimately rupture, causing subarachnoid hemorrhage (SAH). The risk of aneurysm rupture is associated with several factors, including: aneurysm diameter (>7 mm deemed high risk), [ 6 ] patient's sex (female‐to‐male ratio of 2:1), [ 7,8 ] hypertension, and smoking. [ 8 ] This risk can be mitigated by treatment at the time when the aneurysm is incidentally detected prior to rupture.…”

Intraoperative Complications of Endovascular Treatment of Intracranial Aneurysms with Coiling or Balloon-assisted Coiling in a Prospective Multicenter Cohort of 1088 Participants: Analysis of Recanalization after Endovascular Treatment of Intracranial Aneurysm (ARETA) Study

“…The Analysis of Recanalization after Endovascular Treatment (ARETA) study is a publicly funded multicenter prospective French study to analyze participant, aneurysm, and technical factors that affect aneurysm recanalization after endovascular treatment (2). A large cohort of 1289 participants with ruptured or unruptured aneurysms undergoing endovascular treatment were enrolled in 16 neurointerventional centers between December 2013 and May 2015.…”

Endovascular treatment of intracranial aneurysms: A single center experience

“…Saccular aneurysm, which is the most common type, looks like sacs or berries sticking out of a side of a blood vessel wall. Most of these saccular aneurysms have a "neck" region that may or may not be visualized during surgery (9,10). Saccular aneurysms are associated with growth and rupture.…”