Journal article
Flow Diversion for Intracranial Aneurysms With Incorporated Branch: A Subanalysis From the SEASE International Registry
Stroke: vascular and interventional neurology, Vol.4(6), 001448
10/25/2024
DOI: 10.1161/SVIN.124.001448
Appears in UI Libraries Support Open Access
Abstract
BACKGROUND The presence of an incorporated branch as well as its anatomical relationship to the intracranial aneurysms (IAs) and the parent artery may affect the occlusion outcome following flow diversion. This study evaluated the safety and effectiveness of the cobalt‐chromium Surpass Evolve (Stryker), a 64‐wire flow diversion device for the treatment of IAs with incorporated branches. METHODS This subanalysis uses data from the SEASE (Safety and Effectiveness Assessment of Surpass Evolve) registry to retrieve data related to IAs with incorporated branches. Those IAs were classified by a core lab into 4 categories based on their anatomical relationship to the parent artery and branch: (A) sidewall anatomic, (B) sidewall hemodynamic, (C) neck branch, and (D) dome branch. We compared the outcomes based on their incorporated branch's relation to the dome (A–C versus D). RESULTS This study included 67 patients and IAs. Most IAs were in the posterior communicating artery (46.3%), with a median size of 4.35 mm. Age, sex, comorbidities, baseline functional‐status, and IA features were similar between the 2 groups. Among those, 53 (79.1%) had branches emerging from the dome, and 14 (20.9%) had branches originating from other locations (A = 7, B = 2, and C = 5). At a median imaging follow‐up of 10.5 months, complete occlusion was lower in IAs with a branch from the sac compared with those with the neck (60.8% versus 92.9%; P = 0.026), with an overall occlusion of 67.7%. Thromboembolic and hemorrhagic complications, as well as retreatment, were reported in 1.6% and 3.1% of cases, respectively, with no significant differences between groups. CONCLUSION Our analysis underscores the influence of branch origin on occlusion rates, with the neck‐originating branch demonstrating higher occlusion rates. These insights emphasize the role of anatomical considerations in treatment strategies, follow‐up timelines, and designing future clinical trials. Further studies are warranted to explore these variations across different flow diversion technologies.
Details
- Title: Subtitle
- Flow Diversion for Intracranial Aneurysms With Incorporated Branch: A Subanalysis From the SEASE International Registry
- Creators
- Mahmoud Dibas - University of IowaJuan Vivanco-Suarez - University of IowaMilagros Galecio-Castillo - University of IowaDemetrius Klee Lopes - The Spine InstituteRicardo A. Hanel - Baptist Medical Center JacksonvilleAaron Rodriguez-Calienes - Universidad Científica del SurGustavo M. Cortez - Baptist Medical Center JacksonvilleJohanna T. Fifi - Mount Sinai Health SystemAlex Devarajan - Mount Sinai Health SystemGabor Toth - Cleveland ClinicThomas E. Patterson - Cleveland ClinicDavid Altschul - Montefiore Medical CenterVitor M. Pereira - St. Michael's HospitalXiao Yu Eileen Liu - St. Michael's HospitalAjit S. Puri - University of Massachusetts Chan Medical SchoolAnna L. Kühn - University of Massachusetts Chan Medical SchoolWaldo R. Guerrero - University of South FloridaPriyank Khandelwal - Robert Wood Johnson University HospitalIvo Bach - Robert Wood Johnson University HospitalPeter T. Kan - The University of Texas Medical Branch at GalvestonGautam Edhayan - The University of Texas Medical Branch at GalvestonCurtis Given - Central Baptist HospitalBradley A. Gross - University of PittsburghSandra Narayanan - Pacific Heart InstituteShahram Derakhshani - Queen's HospitalMario Martinez-Galdamez - Hospital Clínico Universitario de ValladolidSantiago Ortega-Gutierrez - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Stroke: vascular and interventional neurology, Vol.4(6), 001448
- Publisher
- Wiley; HOBOKEN
- DOI
- 10.1161/SVIN.124.001448
- ISSN
- 2694-5746
- eISSN
- 2694-5746
- Grant note
- Stryker Neurovascular
Stryker Neurovascular funded this study through an investigator-initiated grant.The funding source was not involved in study design, monitoring, datacollection, statistical analyses, interpretation of results, or manuscript writing.
- Language
- English
- Electronic publication date
- 10/25/2024
- Academic Unit
- Neurosurgery; Radiology; Neurology
- Record Identifier
- 9984740859902771
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