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Kaiser DPO, Boulouis G, Soize S, Maus V, Fischer S, Lobsien D, Klisch J, Styczen H, Deuschl C, Abdullayev N, Kabbasch C, Jamous A, Behme D, Janot K, Bellanger G, Cognard C, Pierot L, Gawlitza M. Flow Diversion for ICA Aneurysms with Compressive Neuro-Ophthalmologic Symptoms: Predictors of Morbidity, Mortality, and Incomplete Aneurysm Occlusion. AJNR Am J Neuroradiol 2022; 43:998-1003. [PMID: 35738674 DOI: 10.3174/ajnr.a7550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/12/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Flow diversion is an effective treatment for aneurysms of the ICA with compression-related neuro-ophthalmologic symptoms, especially when treatment is initiated early after symptom onset and aneurysm occlusion is complete. However, non-negligible complication rates have been reported. Our aim was to identify risk factors for morbidity/mortality and incomplete aneurysm occlusion. MATERIALS AND METHODS We performed a secondary analysis of a previous publication, which included all patients treated with flow diversion for an unruptured aneurysm of the ICA with compression-related symptoms. RESULTS Fifty-four patients with 54 aneurysms (48 women, 88.9%; mean age, 59.2 [SD, 15.9] years; range, 21-86 years) treated with flow diversion were included. We observed morbidity and mortality rates of 7.4% and 3.7%. Increasing age (OR per decade, 3.2; 95% CI, 1.23-8.49; P = .02) and dual-antiplatelet therapy with ticagrelor (OR, 13.9; 95% CI, 1.16-165.97; P = .04) were significantly associated with morbidity/mortality. After a median follow-up of 13.3 [SD, 10.5] months, the rates of complete aneurysm occlusion, neck remnant, and aneurysm remnant were 74%, 14%, and 12%. Incomplete occlusion at follow-up was less frequently observed in aneurysms treated with additional coil embolization (OR, 0.1; 95% CI, 0.01-0.86; P = .04). CONCLUSIONS Although a promising treatment for compressive ICA aneurysms, flow diversion carries a relevant risk for complications and incomplete aneurysm occlusion. Our results may help identify patients in which flow diversion may not be the ideal treatment method. Additional coil embolization increased the likelihood of complete aneurysm occlusion at follow-up.
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Affiliation(s)
- D P O Kaiser
- From the Institute of Neuroradiology (D.P.O.K., M.G.), University Hospital Carl Gustav Carus, Dresden, Germany.,Else Kröner-Fresenius Center for Digital Health (D.P.O.K., M.G.), Technical University Dresden, Dresden, Germany
| | - G Boulouis
- Department of Neuroradiology (G. Boulouis, K.J.), Regional and University Hospital Center Tours, Tours, France
| | - S Soize
- Department of Neuroradiology (S.S., L.P.), Hôpital Maison Blanche, Centre Hospitalier Universitaire Reims, Reims, France
| | - V Maus
- Department of Diagnostic and Interventional Neuroradiology and Nuclear Medicine (V.M., S.F.), University Hospital Knappschaftskrankenhaus Bochum, Universitätsklinik der Ruhr-Universität, Bochum, Germany
| | - S Fischer
- Department of Diagnostic and Interventional Neuroradiology and Nuclear Medicine (V.M., S.F.), University Hospital Knappschaftskrankenhaus Bochum, Universitätsklinik der Ruhr-Universität, Bochum, Germany
| | - D Lobsien
- Department of Diagnostic and Interventional Radiology and Neuroradiology (D.L., J.K.), Helios General Hospital Erfurt, Erfurt, Germany
| | - J Klisch
- Department of Diagnostic and Interventional Radiology and Neuroradiology (D.L., J.K.), Helios General Hospital Erfurt, Erfurt, Germany
| | - H Styczen
- Institute of Diagnostic and Interventional Radiology and Neuroradiology (H.S., C.D.), University Hospital Essen, Essen, Germany
| | - C Deuschl
- Institute of Diagnostic and Interventional Radiology and Neuroradiology (H.S., C.D.), University Hospital Essen, Essen, Germany
| | - N Abdullayev
- Department of Diagnostic and Interventional Radiology (N.A., C.K.), University Hospital Cologne, Cologne, Germany
| | - C Kabbasch
- Department of Diagnostic and Interventional Radiology (N.A., C.K.), University Hospital Cologne, Cologne, Germany
| | - A Jamous
- Institute of Diagnostic and Interventional Neuroradiology (A.J., D.B.), Universitätsmedizin Göttingen, Göttingen, Germany
| | - D Behme
- Institute of Diagnostic and Interventional Neuroradiology (A.J., D.B.), Universitätsmedizin Göttingen, Göttingen, Germany.,Department of Neuroradiology (D.B.), University Hospital Magdeburg, Magdeburg, Germany
| | - K Janot
- Department of Neuroradiology (G. Boulouis, K.J.), Regional and University Hospital Center Tours, Tours, France
| | - G Bellanger
- Diagnostic and Therapeutic Neuroradiology (G. Bellanger, C.C.), Centre Hospitalier Universitaire Toulouse, Toulouse, France
| | - C Cognard
- Diagnostic and Therapeutic Neuroradiology (G. Bellanger, C.C.), Centre Hospitalier Universitaire Toulouse, Toulouse, France
| | - L Pierot
- Department of Neuroradiology (S.S., L.P.), Hôpital Maison Blanche, Centre Hospitalier Universitaire Reims, Reims, France
| | - M Gawlitza
- From the Institute of Neuroradiology (D.P.O.K., M.G.), University Hospital Carl Gustav Carus, Dresden, Germany .,Else Kröner-Fresenius Center for Digital Health (D.P.O.K., M.G.), Technical University Dresden, Dresden, Germany
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Lognon P, Gariel F, Marnat G, Darcourt J, Constant Dit Beaufils P, Burel J, Shotar E, Hak JF, Fauché C, Kerleroux B, Guédon A, Ognard J, Forestier G, Pop R, Paya C, Veyrières JB, Sporns P, Girot JB, Zannoni R, Zhu F, Crespy A, L'Allinec V, Mihoc D, Rouchaud A, Gentric JC, Ben Hassen W, Raynaud N, Testud B, Clarençon F, Kaczmarek B, Bourcier R, Bellanger G, Boulouis G, Janot K. Prospective assessment of aneurysmal rupture risk scores in patients with subarachnoid hemorrhage: a multicentric cohort. Neuroradiology 2022; 64:2363-2371. [PMID: 35695927 DOI: 10.1007/s00234-022-02987-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/20/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE The natural evolution of unruptured intracranial aneurysms (UIA) is indeed difficult to predict at the individual level. OBJECTIVE In a large prospective multicentric European cohort, we aimed to evaluate whether the PHASES, UCAS, and ELPASS scores in patients with aneurysmal subarachnoid hemorrhage would have predicted a high risk of aneurysmal rupture or growth. METHODS Academic centers treating patients with intracranial aneurysms were invited to prospectively collect de-identified data from all patients admitted at their institution for a subarachnoid hemorrhage-related to intracranial aneurysmal rupture between January 1 and March 31, 2021 through a trainee-led research collaborative network. Each responding center was provided with an electronic case record form (CRF) which collected all the elements of the PHASES, ELAPSS, and UCAS scores. RESULTS A total of 319 patients with aneurysmal subarachnoid hemorrhage were included at 17 centers during a 3-month period. One hundred eighty-three aneurysms (57%) were less than 7 mm. The majority of aneurysms were located on the anterior communicating artery (n = 131, 41%). One hundred eighty-four patients (57%), 103 patients (32%), and 58 (18%) were classified as having a low risk of rupture or growth, according to the PHASES, UCAS, and ELAPSS scores, respectively. CONCLUSION In a prospective study of European patients with aneurysmal subarachnoid hemorrhage, we showed that 3 common risk-assessment tools designed for patients with unruptured intracranial aneurysms would have not identified most patients to be at high or intermediate risk for rupture, questioning their use for decision-making in the setting of unruptured aneurysms.
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Affiliation(s)
- P Lognon
- University Hospital of Tours, Tours, France
| | - F Gariel
- University Hospital of Bordeaux, Bordeaux, France
| | - G Marnat
- University Hospital of Bordeaux, Bordeaux, France
| | - J Darcourt
- University Hospital of Toulouse, Toulouse, France
| | - P Constant Dit Beaufils
- L'institut du Thorax, University of Nantes, INSERM, CNRS, Nantes, France.,University Hospital of Nantes, Nantes, France
| | - J Burel
- University Hospital of Rouen, Rouen, France
| | - E Shotar
- Pitié Salpêtrière Hospital, Paris, France
| | - J F Hak
- University Hospital of Marseille, Marseille, France
| | - C Fauché
- University Hospital of Poitiers, Poitiers, France
| | | | - A Guédon
- Lariboisière Hospital, Paris, France
| | - J Ognard
- University Hospital of Brest, Brest, France
| | - G Forestier
- University Hospital of Limoges, Limoges, France
| | - R Pop
- University Hospital of Strasbourg, Strasbourg, France
| | - C Paya
- University Hospital of Saint-Pierre, Saint-Pierre, La Réunion, France
| | - J B Veyrières
- University Hospital of Saint-Pierre, Saint-Pierre, La Réunion, France
| | - P Sporns
- University Hospital of Basel, Basel, Switzerland.,University Medical Center of Hamburg-Eppendorf, Hamburg, Germany
| | - J B Girot
- University Hospital of Angers, Angers, France
| | - R Zannoni
- University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F Zhu
- University Hospital of Nancy, Nancy, France
| | - A Crespy
- University Hospital of Tours, Tours, France
| | - V L'Allinec
- University Hospital of Angers, Angers, France
| | - D Mihoc
- University Hospital of Strasbourg, Strasbourg, France
| | - A Rouchaud
- University Hospital of Limoges, Limoges, France
| | | | | | - N Raynaud
- University Hospital of Poitiers, Poitiers, France
| | - B Testud
- University Hospital of Marseille, Marseille, France
| | | | | | - R Bourcier
- L'institut du Thorax, University of Nantes, INSERM, CNRS, Nantes, France.,University Hospital of Nantes, Nantes, France
| | - G Bellanger
- University Hospital of Toulouse, Toulouse, France
| | - G Boulouis
- University Hospital of Tours, Tours, France
| | - Kevin Janot
- University Hospital of Tours, Tours, France.
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Afifi K, Bellanger G, Buyck PJ, Zuurbier SM, Garcia-Esperon C, Barboza MA, Costa P, Escudero I, Renard D, Lemmens R, Hinteregger N, Fazekas F, Jimenez-Conde J, Giralt-Steinhauer E, Hiltunen S, Arauz A, Pezzini A, Montaner J, Putaala J, Weimar C, Schlamann M, Gattringer T, Tatlisumak T, Coutinho JM, Demaerel P, Thijs V. Correction to: Features of intracranial hemorrhage in cerebral venous thrombosis. J Neurol 2020; 267:3299-3300. [PMID: 32785839 DOI: 10.1007/s00415-020-10082-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The original version of this article unfortunately contained mistakes. The correct information is given below.
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Affiliation(s)
- K Afifi
- Department of Neurology, Menoufia University, Al Minufya, Menoufia, Egypt.,Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy Street, Heidelberg, VIC, 3084, Australia
| | - G Bellanger
- Department of Neuroradiology, Purpan University Hospital, Toulouse, France.,Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy Street, Heidelberg, VIC, 3084, Australia
| | - P J Buyck
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - S M Zuurbier
- Department of Neurology, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands
| | - C Garcia-Esperon
- Department of Neurology, John Hunter Hospital, University of Newcastle, Newcastle, Australia
| | - M A Barboza
- Stroke Department, Instituto Nacional de Neurología Y Neurocirugía Dr. Manuel Velasco Suárez, México City, México
| | - P Costa
- Department of Head and Neck, Neurology Clinic, University of Brescia, Brescia, Italy
| | - I Escudero
- Neurology Department, University Hospital Virgen del Rocio, Sevilla, Spain.,Neurovascular Lab, Instituto de Biomedicina de Sevilla, Sevilla, Spain
| | - D Renard
- Department of Neurology, Nîmes University Hospital, Nîmes, France
| | - R Lemmens
- Department of Neurosciences, Experimental Neurology and Leuven Institute for Neuroscience and Disease (LIND), KU Leuven-University of Leuven, Leuven, Belgium.,Laboratory of Neurobiology, Center for Brain and Disease Research, VIB, Leuven, Belgium.,Department of Neurology, University Hospitals Leuven, Leuven, Belgium
| | - N Hinteregger
- Department of Radiology, Division of Neuroradiology, Vascular and Interventional Radiology, Medical University of Graz, Graz, Austria
| | - F Fazekas
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - J Jimenez-Conde
- Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar, Barcelona, Spain.,Universitat Autònoma de Barcelon, Barcelona, Spain
| | - E Giralt-Steinhauer
- Department of Neurology, Neurovascular Research Group, IMIM-Hospital del Mar, Barcelona, Spain.,Universitat Autònoma de Barcelon, Barcelona, Spain
| | - S Hiltunen
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland
| | - A Arauz
- Stroke Department, Instituto Nacional de Neurología Y Neurocirugía Dr. Manuel Velasco Suárez, México City, México
| | - A Pezzini
- Department of Clinical and Experimental Sciences, Neurology Clinic University of Brescia, Brescia, Italy
| | - J Montaner
- Neurovascular Lab, Instituto de Biomedicina de Sevilla, Sevilla, Spain.,Department of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain
| | - J Putaala
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland
| | - C Weimar
- Institute of Medical Informatics, Biometry and Epidemiology and Department of Neurology, University Hospital Essen, Essen, Germany
| | - Marc Schlamann
- Institute for Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - T Gattringer
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - T Tatlisumak
- Department of Neurology, Helsinki University Hospital, Helsinki, Finland.,Department of Clinical Neuroscience/Neurology, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.,Department of Neurology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - J M Coutinho
- Department of Neurology, Amsterdam University Medical Centers, Location Academic Medical Center, Amsterdam, The Netherlands
| | - P Demaerel
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - V Thijs
- Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, 245 Burgundy Street, Heidelberg, VIC, 3084, Australia. .,Department of Neurology, Austin Health, Heidelberg, VIC, Australia.
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Affiliation(s)
- G. Bellanger
- Commissariat á l’Energie Atomique, Centre d’Etudes de Valduc Department Tritium-137, F21120 Is sur Tille, France
| | - J. J. Rameau
- Laboratoire d’Electrochimie et de Physicochimie des Matériaux et des Interfaces Ecole Nationale Sup#x00E9;rieure d’Electrochimie et d’Electrométallurgie Institut National Polytechnique de Grenoble, Domaine Universitaire B.P. 75, F38402, Saint Martin d’Hères, France
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Affiliation(s)
- G. Bellanger
- Commissariat à I’Energie Atomique Centre d’Etudes de Valduc, F21120 Is sur Tille, France
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Affiliation(s)
- G. Bellanger
- Commissariat á l’Energie Atomique, Department Tritium-137 Centre d’Etudes de Valduc, F21120, Is sur Tille, France
| | - J. J. Rameau
- Domaine Universitaire, C.R.E.M.G.P., E.N.S.E.E.G./I.N.P.G. B.P. 75, F38402, Saint Martin d’Hères, France
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Bellanger G. Enrichment of slightly concentrated tritiated water by electrolysis using a palladium cathode coated on ionic solid polymer membrane—Design and results. Fusion Engineering and Design 2007. [DOI: 10.1016/j.fusengdes.2007.03.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Bellanger G, Rameau J. Corrosion of titanium nitride deposits on AISI 630 stainless steel used in radioactive water with and without chloride at pH 11. Electrochim Acta 1995. [DOI: 10.1016/0013-4686(94)00326-v] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Dong PK, Bellanger G, Leger L. [Mechanism of formation of pancreatic calculi]. J Chir (Paris) 1972; 103:119-26. [PMID: 5054840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Hureau J, Bellanger G, Vayre P, Chatelin CL. [Stenosis of an old latero-lateral ileo-ileal anastomosis]. Sem Hop 1969; 45:2549-52. [PMID: 4312170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Lavernhe J, Bellanger G, van Peteghem J. [Subjective and objective reactions to disturbances of circadian rhythm following long-distance flights from east to west and vice versa]. Presse Med (1893) 1968; 76:347-8. [PMID: 5644249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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