An update to the Raymond–Roy Occlusion Classification of intracranial aneurysms treated with coil embolization
Justin R Mascitelli,Henry Moyle,Eric K. Oermann,Maritsa F Polykarpou,A Patel,Amish H. Doshi,Yakov Gologorsky,Joshua B. Bederson,Aman B. Patel +8 more
TLDR
The MRRC has the potential to expand the definition of adequate coil embolization, possibly decrease procedural risk, and help endovascular neurosurgeons predict which patients need closer angiographic follow-up.Abstract:
Background The Raymond–Roy Occlusion Classification (RROC) is the standard for evaluating coiled aneurysms (Class I: complete obliteration; Class II: residual neck; Class III: residual aneurysm), but not all Class III aneurysms behave the same over time. Methods This is a retrospective review of 370 patients with 390 intracranial aneurysms treated with coil embolization. A Modified Raymond–Roy Classification (MRRC), in which Class IIIa designates contrast within the coil interstices and Class IIIb contrast along the aneurysm wall, was applied retrospectively. Results Class IIIa aneurysms were more likely to improve to Class I or II than Class IIIb aneurysms (83.34% vs 14.89%, p Conclusions We propose the MRRC to further differentiate Class III aneurysms into those likely to progress to complete occlusion and those likely to remain incompletely occluded or to worsen. The MRRC has the potential to expand the definition of adequate coil embolization, possibly decrease procedural risk, and help endovascular neurosurgeons predict which patients need closer angiographic follow-up. These findings need to be validated in a prospective study with independent blinded angiographic grading.read more
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The Society for Vascular Surgery clinical practice guidelines on the management of visceral aneurysms.
Rabih A. Chaer,Christopher J. Abularrage,Dawn M. Coleman,Mohammad H. Eslami,Vikram S. Kashyap,Caron B. Rockman,M. Hassan Murad +6 more
TL;DR: These guidelines include evidence-based size thresholds for repair of aneurysms of the renal arteries, splenic artery, celiac artery, and hepatic artery, among others, and specific open surgical and endovascular repair strategies are discussed.
Journal ArticleDOI
Wide-neck bifurcation aneurysms of the middle cerebral artery and basilar apex treated by endovascular techniques: a multicentre, core lab adjudicated study evaluating safety and durability of occlusion (BRANCH).
Reade De Leacy,Kyle M Fargen,Justin R Mascitelli,Johanna T Fifi,Lena Turkheimer,Xiangnan Zhang,Aman B. Patel,Matthew J. Koch,Aditya S Pandey,D. Andrew Wilkinson,Julius Griauzde,Robert F. James,Enzo Fortuny,Aurora S Cruz,Alan S. Boulos,Emad Nourollahzadeh,Alexandra R. Paul,Eric Sauvageau,Ricardo A. Hanel,Pedro Aguilar-Salinas,Roberta Novakovic,Babu G. Welch,Ranyah Almardawi,Gaurav Jindal,Harish Shownkeen,Elad I. Levy,Adnan H. Siddiqui,J Mocco +27 more
TL;DR: The need for novel endovascular devices specifically designed to treat complex intracranial aneurysms, as well as the importance of core lab adjudication in assessing outcomes in such a trial, are demonstrated.
Journal ArticleDOI
The Neuroform Atlas stent to assist coil embolization of intracranial aneurysms: a multicentre experience.
Christian Ulfert,Mirko Pham,Michael Sonnberger,Franco Amaya,Johannes Trenkler,Martin Bendszus,Markus A Möhlenbruch +6 more
TL;DR: Deployment of the Neuroform Atlas microstent is a safe and effective method for the treatment of intracranial wide-necked aneurysms and was technically successful in all cases.
Journal ArticleDOI
NeuroForm Atlas Stent-Assisted Coiling: Preliminary Results.
Michelle F M Ten Brinck,Joost de Vries,Ronald H. M. A. Bartels,J André Grotenhuis,Hieronymus D. Boogaarts +4 more
TL;DR: NeuroForm Atlas SAC is a feasible way to treat ruptured and unruptured wide-neck aneurysms that are not amenable to conventional coiling or clipping and aneurysm occlusion and favorable clinical outcome are consistent with previously reported rates for SAC of wide- neck aneurYSms with other devices.
Journal ArticleDOI
Stratification of recanalization for patients with endovascular treatment of intracranial aneurysms.
TL;DR: This is the first comprehensive model that has been developed to quantitatively predict the risk of retreatment after endovascular therapy and constructed the Aneurysm Recanalization Stratification Scale to enhance this decision-making process.
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Andrew J. Molyneux,Richard S. C. Kerr,Ly-Mee Yu,Mike Clarke,Mary Sneade,Julia A. Yarnold,Peter Sandercock +6 more
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Jean Raymond,François Guilbert,Alain Weill,Stavros A. Georganos,Louis Juravsky,Anick Lambert,Julie Lamoureux,Miguel Chagnon,Daniel Roy +8 more
TL;DR: Variables determined to be significant predictors of a recurrence included aneurysm size ≥10 mm, treatment during the acute phase of rupture, incomplete initial occlusions, and duration of follow-up, and long-term monitoring of patients treated by endosaccular coiling is mandatory.
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Endovascular Treatment of Unruptured Aneurysms
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Robert A. Willinsky,Steve M Taylor,Karel G. terBrugge,Richard I. Farb,George Tomlinson,Walter Montanera +5 more
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Predictors of Rehemorrhage After Treatment of Ruptured Intracranial Aneurysms: The Cerebral Aneurysm Rerupture After Treatment (CARAT) Study
S. Claiborne Johnston,Christopher F. Dowd,Randall T. Higashida,Michael T. Lawton,Gary Duckwiler,Daryl R. Gress +5 more
TL;DR: Degree of aneurysm occlusion after the initial treatment is a strong predictor of the risk of subsequent rupture in patients presenting with subarachnoid hemorrhage, which justifies attempts to completely occlude aneurYSms.