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    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)

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    Author
    Fargen, K.M.
    Mascitelli, J.R.
    De Leacy, R.A.
    Date
    2019
    Journal
    Journal of NeuroInterventional Surgery
    Publisher
    BMJ Publishing Group
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1136/neurintsurg-2018-013771
    Abstract
    Background and purpose BRANCH (wide-neck bifurcation aneurysms of the middle cerebral artery and basilar apex treated by endovascular techniques) is a multicentre, retrospective study comparing core lab evaluation of angiographic outcomes with self-reported outcomes. Materials and methods Consecutive patients were enrolled from 10 US centres, aged between 18 and 85 with unruptured wide-neck middle cerebral artery (MCA) or basilar apex aneurysms treated endovascularly. Patient demographics, aneurysm morphology, procedural information, mortality and morbidity data and core lab and self-reported modified Raymond Roy (RR) outcomes were obtained. Results 115 patients met inclusion criteria. Intervention-related mortality and significant morbidity rates were 1.7% (2/115) and 5.8% (6/103) respectively. Core lab adjudicated RR1 and 2 occlusion rates at follow-up were 30.6% and 32.4% respectively. The retreatment rate within the follow-up window was 10/115 (8.7%) and in stent stenosis at follow-up was 5/63 (7.9%). Self-reporting shows a statistically significant direction to angiographic RR one outcomes at follow-up compared with core lab evaluation, with OR 1.75 (95% CI 1.08 to 2.83). Conclusion Endovascular treatment of wide-neck MCA and basilar apex aneurysms resulted in a core lab adjudicated RR1 occlusion rate of 30.6%. Self-reported results at follow-up favour better angiographic outcomes, with OR 1.75 (95% CI 1.08 to 2.83). These data demonstrate 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. Copyright Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019.
    Keyword
    aneurysm
    balloon
    coil
    intervention
    stent
    Identifier to cite or link to this item
    https://www.scopus.com/inward/record.uri?eid=2-s2.0-85054852218&doi=10.1136%2fneurintsurg-2018-013771&partnerID=40&md5=bed2ad71ed1f1091dda8e0513348a176; http://hdl.handle.net/10713/10820
    ae974a485f413a2113503eed53cd6c53
    10.1136/neurintsurg-2018-013771
    Scopus Count
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    UMB Open Access Articles 2019

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