Point--TAR: A Useful Index to Follow-Up Coiled Intracranial Aneurysms?

Piérot, Laurent; Fiehler, Jens; White, Phil

doi:10.3174/ajnr.a4119

Cited by 8 publications

(6 citation statements)

References 12 publications

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“…It is difficult to compare re-treatment rates from one study to another, as indications for re-treatment are not well established and vary considerably from one center to another. 22 However, the very low re-treatment rate observed with WEB is comparable to the lowest rate of re-treatment reported in the largest coiling series: HELPS trial, 3.0% with both bare and hydrogel coils; CLARITY study, 3.3% for aneurysms treated with bare coils, but 9.5% in the matrix group; Cerecyte Coil Trial, 3.5% in the bare coils group and 7.7% in the Cerecyte coils group; MAPS wide-neck aneurysm subset, 13.7% for coils alone and 14.1% for stent and coils. 19 21 23 24 …”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series

Piérot

Moret

Barreau

et al. 2017

J NeuroIntervent Surg

172

130

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BackgroundFlow disruption with the WEB is an innovative endovascular approach for treatment of wide-neck bifurcation aneurysms. Initial studies have shown a low complication rate with good efficacy.PurposeTo report clinical and anatomical results of the WEB treatment in the cumulative population of three Good Clinical Practice (GCP) studies: WEBCAST (WEB Clinical Assessment of Intrasaccular Aneurysm), French Observatory, and WEBCAST-2.MethodsWEBCAST, French Observatory, and WEBCAST-2 are single-arm, prospective, multicenter, GCP studies dedicated to the evaluation of WEB treatment. Clinical data were independently evaluated. Postoperative and 1-year aneurysm occlusion was independently evaluated using the 3-grade scale: complete occlusion, neck remnant, and aneurysm remnant.ResultsThe cumulative population comprised 168 patients with 169 aneurysms, including 112 female subjects (66.7%). The patients' ages ranged between 27 and 77 years (mean 55.5±10.2 years). Aneurysm locations were middle cerebral artery in 86/169 aneurysms (50.9%), anterior communicating artery in 36/169 (21.3%), basilar artery in 30/169 (17.8%), and internal carotid artery terminus in 17/169 (10.1%). The aneurysm was ruptured in 14/169 (8.3%). There was no mortality at 1 month and procedure/device-related morbidity was 1.2% (2/168). At 1 year, complete aneurysm occlusion was observed in 81/153 aneurysms (52.9%), neck remnant in 40/153 aneurysms (26.1%), and aneurysm remnant in 32/153 aneurysms (20.9%). Re-treatment was carried out in 6.9%.ConclusionsThis series is at the moment the largest prospective, multicenter, GCP series of patients with aneurysms treated with WEB. It shows the high safety and good mid-term efficacy of this treatment.Clinical trial registrationFrench Observatory: Unique identifier (NCT18069); WEBCAST and WEBCAST-2: Unique identifier (NCT01778322).

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series

Piérot

Moret

Barreau

et al. 2017

J NeuroIntervent Surg

172

130

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“…Nevertheless, aneurysm or neck reopening occurs in approximately 20% of patients, necessitating retreatment in about half of them 2. There is no consensus or recommendations regarding retreatment after aneurysm coiling 3. Indications for retreatment have to take into account the risks of retreatment and the risk of bleeding/rebleeding.…”

Section: Discussionmentioning

confidence: 99%

Rebleeding of a neck remnant in a case of ruptured aneurysm initially treated with coils

Benaissa

Piérot

2015

BMJ Case Reports

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“…5,6 This finding renders questionable retreatment as a primary outcome measure in studies comparing different types of aneurysm treatment. 11 Although the necessity of retreatment is a meaningful outcome parameter for patients, it adds much variability if the recommendation for retreatment varies widely among therapists. The estimation of the need for retreatment is a subjective end point, the basic prerequisite of which is the presence of recanalization as an indicator of higher rupture or rerupture risk.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing Confidence in Diagnostic Ratings and Retreatment Recommendations in Coiled Aneurysms

Ernst¹,

Kriston

Groth³

et al. 2018

AJNR Am J Neuroradiol

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Although overall confidence in the diagnostic rating was high, our study confirms the suboptimal interrater reliability of visual assessment of aneurysm occlusion as well as retreatment recommendations, rendering both questionable as primary outcome measures. Besides recurrence status, recommendation of retreatment is significantly influenced by patient age, aneurysm neck width, and characteristics of the therapist.

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Point--TAR: A Useful Index to Follow-Up Coiled Intracranial Aneurysms?

Cited by 8 publications

References 12 publications

Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series

Safety and efficacy of aneurysm treatment with WEB in the cumulative population of three prospective, multicenter series

Rebleeding of a neck remnant in a case of ruptured aneurysm initially treated with coils

Factors Influencing Confidence in Diagnostic Ratings and Retreatment Recommendations in Coiled Aneurysms

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