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Chiaroni PM, Guerra X, Cortese J, Burel J, Courret T, Constant Dit Beaufils P, Agripnidis T, Leonard-Lorant I, Fauché C, Bankole NDA, Forestier G, L'allinec V, Sporns PB, Gueton G, Lorena N, Psychogios MN, Girot JB, Rouchaud A, Janot K, Raynaud N, Pop R, Hak JF, Kerleroux B, Bourcier R, Marnat G, Papagiannaki C, Sourour NA, Clarençon F, Shotar E. Location specific rupture risk of intracranial aneurysms: case of ophthalmic aneurysms. J Neurointerv Surg 2023:jnis-2023-020909. [PMID: 37798103 DOI: 10.1136/jnis-2023-020909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/15/2023] [Accepted: 09/13/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Aneurysm location is a key element in predicting the rupture risk of an intracranial aneurysm. A common impression suggests that pure ophthalmic aneurysms are under-represented in ruptured intracranial aneurysms (RIAs). The purpose of this study was to specifically evaluate the risk of rupture of ophthalmic aneurysms compared with other aneurysm locations. METHODS This multicenter study compared the frequency of ophthalmic aneurysms in a prospective cohort of RIAs admitted to 13 neuroradiology centers between January 2021 and March 2021, with a retrospective cohort of patients with unruptured intracranial aneurysms (UIAs) who underwent cerebral angiography at the same neuroradiology centers during the same time period. RESULTS 604 intracranial aneurysms were included in this study (355 UIAs and 249 RIAs; mean age 57 years (IQR 49-65); women 309/486, 64%). Mean aneurysm size was 6.0 mm (5.3 mm for UIAs, 7.0 mm for RIAs; P<0.0001). Aneurysm shape was irregular for 37% UIAs and 73% RIAs (P<0.0001). Ophthalmic aneurysms frequency was 14.9% of UIAs (second most common aneurysm location) and 1.2% of RIAs (second least common aneurysm location; OR 0.07 (95% CI 0.02 to 0.23), P<0.0001). CONCLUSIONS Ophthalmic aneurysms seem to have a low risk of rupture compared with other intracranial aneurysm locations. This calls for a re-evaluation of the benefit-risk balance when considering preventive treatment for ophthalmic aneurysms.
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Affiliation(s)
| | - Xavier Guerra
- Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France
- Sainte Anne Hospital, Paris, France
| | - Jonathan Cortese
- Interventional Neuroradiology, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Julien Burel
- Radiology, Rouen University Hospital, Rouen, France
| | - Thomas Courret
- Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | | | | | - Ian Leonard-Lorant
- Interventional Neuroradiology Department, Strasbourg University Hospital, Strasbourg, France
| | | | | | - Géraud Forestier
- Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | | | - Peter B Sporns
- Department of Neuroradiology, University Hospital Basel, Basel, Switzerland
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gaelle Gueton
- Interventional Neuroradiology Department, Saint-Etienne University Hospital, Saint-Etienne, France
| | - Nico Lorena
- Interventional Neuroradiology Department, Saint-Etienne University Hospital, Saint-Etienne, France
| | | | | | - Aymeric Rouchaud
- Interventional Neuroradiology, Centre Hospitalier Universitaire de Limoges, Limoges, France
- University of Limoges, CNRS, XLIM, UMR 7252, Limoges, France
| | - Kevin Janot
- Neuroradiology, University Hospital of Tours, Tours, France
| | | | - Raoul Pop
- Interventional Neuroradiology Department, Strasbourg University Hospital, Strasbourg, France
| | | | | | - Romain Bourcier
- Diagnostic and Interventional Neuroradiology Department, CHU Nantes, Nantes, France
| | - Gaultier Marnat
- Neuroradiology Department, Bordeaux University Hospital, Bordeaux, France
| | | | | | - Frédéric Clarençon
- Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France
- Sorbonne University, Paris, France
| | - Eimad Shotar
- Department of Neuroradiology, University Hospital Pitié Salpêtrière, Paris, France
- INSERM, CNRS, Vision Institute, Sorbonne University, Paris, France
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Janot K, Charbonnier G, Marnat G, Sporns P, Burel J, Papagiannaki C, Forestier G, Hak JF, Agripnidis T, Bolognini F, Lebedinsky PA, Ifergan H, Bibi R, Herbreteau D, Adeniran Bankole ND, Biondi A, Barreau X, Guédon A, Shotar E, Clarençon F, Kerleroux B, Boulouis G, Bala F, Rouchaud A. Persistent flow inside the Woven EndoBridge at angiographic follow-up: A multicenter study. Interv Neuroradiol 2023:15910199231185805. [PMID: 37403459 DOI: 10.1177/15910199231185805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The occurrence of persistent intra-device filling (BOSS 1, using the Bicêtre Occlusion Scale Score (BOSS)) in aneurysms treated with a Woven Endobridge (WEB) device is infrequent based on angiographic follow-up. To date, three monocentric case series were published studying BOSS 1 cases. Through a multicenter retrospective study, we aimed to report the incidence, and risk factors of intra-WEB persistent filling. METHODS We reached out to European academic centers that treat patients using WEB devices and requested de-identified data of patients treated with a WEB device and underwent angiographic follow-up, at least 3 months after embolization, to assess the BOSS 1 occlusion score. We compared baseline characteristics, treatment modalities, and aneurysm data of the included BOSS 1 patients with those of a control group consisting of non-BOSS 1 patients (n = 116) who had an available angiographic follow-up. Univariable and multivariable models were employed for analysis. RESULTS Among the pooled sample of 591 aneurysms treated with WEB, the rate of persistent flow (BOSS 1) at angiographic follow-up was 5.2% (n = 31 out of 591), performed after an average of 8.7 ± 6.3 months. In the multivariable-adjusted analysis, dual antiplatelet therapy in the postoperative period (adjusted odds ratio [aOR] 4.3 [95% CI 1.3-14.2]), and WEB undersizing (aOR 10.8 [95% CI 2.9-40]) were independently associated with a BOSS 1 persistent flow result. CONCLUSION Persistent blood flow within the WEB device during angiographic follow-up (BOSS 1) is an uncommon occurrence. Our findings indicate that post-procedural dual antiplatelet therapy and undersizing of the WEB device are independently associated with the presence of BOSS 1 at follow-up.
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Affiliation(s)
- Kevin Janot
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Guillaume Charbonnier
- Interventional Neuroradiology Department, University Hospital of Besançon, Besançon, France
| | - Gaultier Marnat
- Diagnostic and Interventional Neuroradiology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Peter Sporns
- Interventional Neuroradiology Department, University Hospital of Basel, Basel, Switzerland
- Interventional Neuroradiology Department, University Medical Center of Hamburg-Eppendorf, Hamburg, Germany
| | - Julien Burel
- Interventional Neuroradiology Department, University Hospital of Rouen, Rouen, France
| | | | - Geraud Forestier
- Interventional Neuroradiology Department, University Hospital of Limoges, Limoges, France
| | - Jean-Francois Hak
- Interventional Neuroradiology Department, University Hospital of Marseille, Marseille, France
| | - Thibault Agripnidis
- Interventional Neuroradiology Department, University Hospital of Marseille, Marseille, France
| | | | | | - Heloise Ifergan
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Richard Bibi
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Denis Herbreteau
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | | | - Alessandra Biondi
- Interventional Neuroradiology Department, University Hospital of Besançon, Besançon, France
| | - Xavier Barreau
- Diagnostic and Interventional Neuroradiology Department, University Hospital of Bordeaux, Bordeaux, France
| | - Alexis Guédon
- Interventional Neuroradiology Department, Lariboisière Hospital, Paris, France
| | - Eimad Shotar
- Neuroradiology Department, Pitié Salpêtrière Hospital, Paris, France
| | | | - Basile Kerleroux
- Interventional Neuroradiology Department, Saint Anne Hospital, Paris, France
| | - Grégoire Boulouis
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Fouzi Bala
- Interventional Neuroradiology Department, University Hospital of Tours, Tours, France
| | - Aymeric Rouchaud
- Interventional Neuroradiology Department, University Hospital of Limoges, Limoges, France
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Kerleroux B, Agripnidis T, Frandon J, Hak JF. Validation of mechanical thrombectomy for patients with Basilar-Artery occlusion. Anaesth Crit Care Pain Med 2023; 42:101185. [PMID: 36509388 DOI: 10.1016/j.accpm.2022.101185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Basile Kerleroux
- Department of Neuroradiology, APHM La Timone, Marseille, France; Department of Radiology, Centre Hospitalier de Bastia, Bastia, France.
| | - Thibault Agripnidis
- Department of Neuroradiology, APHM La Timone, Marseille, France; LiiE, Aix Marseille University, Marseille, France; CERIMED, Aix Marseille University, 27 Bd Jean Moulin, 13005, Marseille, France
| | - Julien Frandon
- IMAGINE UR UM 103, University of Montpellier, Department of Medical Imaging, Nîmes University Hospital, Nîmes, France
| | - Jean-François Hak
- Department of Neuroradiology, APHM La Timone, Marseille, France; LiiE, Aix Marseille University, Marseille, France; CERIMED, Aix Marseille University, 27 Bd Jean Moulin, 13005, Marseille, France
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