Immediate Clinical Outcome of Patients Harboring Unruptured Intracranial Aneurysms Treated by Endovascular Approach : Results of the ATENA Study
The management of unruptured intracranial aneurysms remains controversial and the results of endovascular treatment are not precisely known because no prospective data exist. The first prospective multicenter study (ATENA) was conducted in Canada and France to determine clinical outcome and risks of...
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| Veröffentlicht in: | Stroke (1970) 2008-09, Vol.39 (9), p.2497-2504 |
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| creator | PIEROT, Laurent SPELLE, Laurent VITRY, Fabien |
| description | The management of unruptured intracranial aneurysms remains controversial and the results of endovascular treatment are not precisely known because no prospective data exist. The first prospective multicenter study (ATENA) was conducted in Canada and France to determine clinical outcome and risks of this treatment.
Six hundred forty-nine patients harboring a total of 1100 aneurysms from 27 Canadian and French neurointerventional centers were prospectively and consecutively treated by endovascular coil embolization. Of these, 739 unruptured intracranial aneurysms were treated during 700 procedures. Aneurysms were selectively treated in the great majority of cases (98.4%) with coils alone (54.5%), the balloon remodeling technique (37.3%), or stenting (7.8%).
Endovascular treatment failed in 32 aneurysms (4.3%). Technical adverse events with or without clinical modification were encountered in 15.4% of patients and included thromboembolic complications (7.1% per procedure), intraoperative rupture (2.6% per procedure), and device-related problems (2.9% per procedure). Adverse events associated with transient or permanent neurological deficit or death were encountered in 5.4% of cases. The 1-month morbidity and mortality rates were 1.7% and 1.4%, respectively.
Endovascular treatment of unruptured intracranial aneurysms is feasible in a high percentage of cases with low morbidity and mortality rates. |
| doi_str_mv | 10.1161/STROKEAHA.107.512756 |
| format | Article |
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Six hundred forty-nine patients harboring a total of 1100 aneurysms from 27 Canadian and French neurointerventional centers were prospectively and consecutively treated by endovascular coil embolization. Of these, 739 unruptured intracranial aneurysms were treated during 700 procedures. Aneurysms were selectively treated in the great majority of cases (98.4%) with coils alone (54.5%), the balloon remodeling technique (37.3%), or stenting (7.8%).
Endovascular treatment failed in 32 aneurysms (4.3%). Technical adverse events with or without clinical modification were encountered in 15.4% of patients and included thromboembolic complications (7.1% per procedure), intraoperative rupture (2.6% per procedure), and device-related problems (2.9% per procedure). Adverse events associated with transient or permanent neurological deficit or death were encountered in 5.4% of cases. The 1-month morbidity and mortality rates were 1.7% and 1.4%, respectively.
Endovascular treatment of unruptured intracranial aneurysms is feasible in a high percentage of cases with low morbidity and mortality rates.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/STROKEAHA.107.512756</identifier><identifier>PMID: 18617659</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Canada ; Canada - epidemiology ; Cerebral Arteries ; Cerebral Arteries - pathology ; Cerebral Arteries - physiopathology ; Diseases of the nervous system ; Embolization, Therapeutic ; Embolization, Therapeutic - adverse effects ; Embolization, Therapeutic - mortality ; Embolization, Therapeutic - statistics & numerical data ; Female ; Follow-Up Studies ; France ; France - epidemiology ; Human health and pathology ; Humans ; Intracranial Aneurysm ; Intracranial Aneurysm - mortality ; Intracranial Aneurysm - pathology ; Intracranial Aneurysm - therapy ; Life Sciences ; Male ; Medical sciences ; Middle Aged ; Neurology ; Postoperative Complications ; Postoperative Complications - epidemiology ; Prospective Studies ; Prostheses and Implants ; Prostheses and Implants - adverse effects ; Prostheses and Implants - statistics & numerical data ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Stents ; Stents - adverse effects ; Stents - statistics & numerical data ; Subarachnoid Hemorrhage ; Subarachnoid Hemorrhage - prevention & control ; Thromboembolism ; Thromboembolism - epidemiology ; Treatment Outcome ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2008-09, Vol.39 (9), p.2497-2504</ispartof><rights>2008 INIST-CNRS</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c354t-f4b913bc1d657ce294b3cbce2242082c593276389155abcb5d5f5f9cb9af37ee3</cites><orcidid>0000-0002-6748-8528</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20612922$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18617659$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://unilim.hal.science/hal-00741687$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>PIEROT, Laurent</creatorcontrib><creatorcontrib>SPELLE, Laurent</creatorcontrib><creatorcontrib>VITRY, Fabien</creatorcontrib><creatorcontrib>ATENA Investigators</creatorcontrib><title>Immediate Clinical Outcome of Patients Harboring Unruptured Intracranial Aneurysms Treated by Endovascular Approach : Results of the ATENA Study</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>The management of unruptured intracranial aneurysms remains controversial and the results of endovascular treatment are not precisely known because no prospective data exist. The first prospective multicenter study (ATENA) was conducted in Canada and France to determine clinical outcome and risks of this treatment.
Six hundred forty-nine patients harboring a total of 1100 aneurysms from 27 Canadian and French neurointerventional centers were prospectively and consecutively treated by endovascular coil embolization. Of these, 739 unruptured intracranial aneurysms were treated during 700 procedures. Aneurysms were selectively treated in the great majority of cases (98.4%) with coils alone (54.5%), the balloon remodeling technique (37.3%), or stenting (7.8%).
Endovascular treatment failed in 32 aneurysms (4.3%). Technical adverse events with or without clinical modification were encountered in 15.4% of patients and included thromboembolic complications (7.1% per procedure), intraoperative rupture (2.6% per procedure), and device-related problems (2.9% per procedure). Adverse events associated with transient or permanent neurological deficit or death were encountered in 5.4% of cases. The 1-month morbidity and mortality rates were 1.7% and 1.4%, respectively.
Endovascular treatment of unruptured intracranial aneurysms is feasible in a high percentage of cases with low morbidity and mortality rates.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Canada</subject><subject>Canada - epidemiology</subject><subject>Cerebral Arteries</subject><subject>Cerebral Arteries - pathology</subject><subject>Cerebral Arteries - physiopathology</subject><subject>Diseases of the nervous system</subject><subject>Embolization, Therapeutic</subject><subject>Embolization, Therapeutic - adverse effects</subject><subject>Embolization, Therapeutic - mortality</subject><subject>Embolization, Therapeutic - statistics & numerical data</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>France</subject><subject>France - epidemiology</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Intracranial Aneurysm</subject><subject>Intracranial Aneurysm - mortality</subject><subject>Intracranial Aneurysm - pathology</subject><subject>Intracranial Aneurysm - therapy</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Postoperative Complications</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Prostheses and Implants</subject><subject>Prostheses and Implants - adverse effects</subject><subject>Prostheses and Implants - statistics & numerical data</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Stents</subject><subject>Stents - adverse effects</subject><subject>Stents - statistics & numerical data</subject><subject>Subarachnoid Hemorrhage</subject><subject>Subarachnoid Hemorrhage - prevention & control</subject><subject>Thromboembolism</subject><subject>Thromboembolism - epidemiology</subject><subject>Treatment Outcome</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkVuLEzEYhoMobl39ByK5UfCiNedMvBtKtcViZbd7PSSZjI3MoZvDQv-FP9ksLfUq4eN534TvAeA9RguMBf5yv7_b_VjV63qBkVxwTCQXL8AMc8LmTJDqJZghRNWcMKVuwJsY_yCECK34a3CDK4Gl4GoG_m6GwbVeJweXvR-91T3c5WSnwcGpg7908m5MEa51MFPw42_4MIZ8TDm4Fm7GFLQNevQlVY8uh1McItwHV_paaE5wNbbTk4429zrA-ngMk7YH-BXeuZj7UlueSAcH6_3qZw3vU25Pb8GrTvfRvbuct-Dh22q_XM-3u--bZb2dW8pZmnfMKEyNxa3g0jqimKHWlAthBFXEckWJFLRSmHNtrOEt73inrFG6o9I5egs-n3sPum-OwQ86nJpJ-2Zdb5vnGUKSYVHJJ1zYT2e2_P8xu5iawUfr-l6PbsqxEYpJJIUqIDuDNkwxBtddmzFqnq01V2tlIpuztRL7cOnPptj4H7poKsDHC1B2qfuurNz6eOUIEpgoQug_RvmiCg</recordid><startdate>20080901</startdate><enddate>20080901</enddate><creator>PIEROT, Laurent</creator><creator>SPELLE, Laurent</creator><creator>VITRY, Fabien</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-6748-8528</orcidid></search><sort><creationdate>20080901</creationdate><title>Immediate Clinical Outcome of Patients Harboring Unruptured Intracranial Aneurysms Treated by Endovascular Approach : Results of the ATENA Study</title><author>PIEROT, Laurent ; SPELLE, Laurent ; VITRY, Fabien</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c354t-f4b913bc1d657ce294b3cbce2242082c593276389155abcb5d5f5f9cb9af37ee3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Canada</topic><topic>Canada - epidemiology</topic><topic>Cerebral Arteries</topic><topic>Cerebral Arteries - pathology</topic><topic>Cerebral Arteries - physiopathology</topic><topic>Diseases of the nervous system</topic><topic>Embolization, Therapeutic</topic><topic>Embolization, Therapeutic - adverse effects</topic><topic>Embolization, Therapeutic - mortality</topic><topic>Embolization, Therapeutic - statistics & numerical data</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>France</topic><topic>France - epidemiology</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Intracranial Aneurysm</topic><topic>Intracranial Aneurysm - mortality</topic><topic>Intracranial Aneurysm - pathology</topic><topic>Intracranial Aneurysm - therapy</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Postoperative Complications</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Prostheses and Implants</topic><topic>Prostheses and Implants - adverse effects</topic><topic>Prostheses and Implants - statistics & numerical data</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Stents</topic><topic>Stents - adverse effects</topic><topic>Stents - statistics & numerical data</topic><topic>Subarachnoid Hemorrhage</topic><topic>Subarachnoid Hemorrhage - prevention & control</topic><topic>Thromboembolism</topic><topic>Thromboembolism - epidemiology</topic><topic>Treatment Outcome</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>PIEROT, Laurent</creatorcontrib><creatorcontrib>SPELLE, Laurent</creatorcontrib><creatorcontrib>VITRY, Fabien</creatorcontrib><creatorcontrib>ATENA Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>PIEROT, Laurent</au><au>SPELLE, Laurent</au><au>VITRY, Fabien</au><aucorp>ATENA Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immediate Clinical Outcome of Patients Harboring Unruptured Intracranial Aneurysms Treated by Endovascular Approach : Results of the ATENA Study</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2008-09-01</date><risdate>2008</risdate><volume>39</volume><issue>9</issue><spage>2497</spage><epage>2504</epage><pages>2497-2504</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><abstract>The management of unruptured intracranial aneurysms remains controversial and the results of endovascular treatment are not precisely known because no prospective data exist. The first prospective multicenter study (ATENA) was conducted in Canada and France to determine clinical outcome and risks of this treatment.
Six hundred forty-nine patients harboring a total of 1100 aneurysms from 27 Canadian and French neurointerventional centers were prospectively and consecutively treated by endovascular coil embolization. Of these, 739 unruptured intracranial aneurysms were treated during 700 procedures. Aneurysms were selectively treated in the great majority of cases (98.4%) with coils alone (54.5%), the balloon remodeling technique (37.3%), or stenting (7.8%).
Endovascular treatment failed in 32 aneurysms (4.3%). Technical adverse events with or without clinical modification were encountered in 15.4% of patients and included thromboembolic complications (7.1% per procedure), intraoperative rupture (2.6% per procedure), and device-related problems (2.9% per procedure). Adverse events associated with transient or permanent neurological deficit or death were encountered in 5.4% of cases. The 1-month morbidity and mortality rates were 1.7% and 1.4%, respectively.
Endovascular treatment of unruptured intracranial aneurysms is feasible in a high percentage of cases with low morbidity and mortality rates.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>18617659</pmid><doi>10.1161/STROKEAHA.107.512756</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-6748-8528</orcidid></addata></record> |
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| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection; Journals@Ovid Complete |
| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Canada Canada - epidemiology Cerebral Arteries Cerebral Arteries - pathology Cerebral Arteries - physiopathology Diseases of the nervous system Embolization, Therapeutic Embolization, Therapeutic - adverse effects Embolization, Therapeutic - mortality Embolization, Therapeutic - statistics & numerical data Female Follow-Up Studies France France - epidemiology Human health and pathology Humans Intracranial Aneurysm Intracranial Aneurysm - mortality Intracranial Aneurysm - pathology Intracranial Aneurysm - therapy Life Sciences Male Medical sciences Middle Aged Neurology Postoperative Complications Postoperative Complications - epidemiology Prospective Studies Prostheses and Implants Prostheses and Implants - adverse effects Prostheses and Implants - statistics & numerical data Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Stents Stents - adverse effects Stents - statistics & numerical data Subarachnoid Hemorrhage Subarachnoid Hemorrhage - prevention & control Thromboembolism Thromboembolism - epidemiology Treatment Outcome Vascular diseases and vascular malformations of the nervous system |
| title | Immediate Clinical Outcome of Patients Harboring Unruptured Intracranial Aneurysms Treated by Endovascular Approach : Results of the ATENA Study |
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