RT Journal Article SR Electronic T1 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) JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP neurintsurg-2018-013771 DO 10.1136/neurintsurg-2018-013771 A1 Reade A De Leacy A1 Kyle M Fargen A1 Justin R Mascitelli A1 Johanna Fifi A1 Lena Turkheimer A1 Xiangnan Zhang A1 Aman B Patel A1 Matthew J Koch A1 Aditya S Pandey A1 D Andrew Wilkinson A1 Julius Griauzde A1 Robert F James A1 Enzo M Fortuny A1 Aurora Cruz A1 Alan Boulos A1 Emad Nourollah-Zadeh A1 Alexandra Paul A1 Eric Sauvageau A1 Ricardo Hanel A1 Pedro Aguilar-Salinas A1 Roberta L Novakovic A1 Babu G Welch A1 Ranyah Almardawi A1 Gaurav Jindal A1 Harish Shownkeen A1 Elad I Levy A1 Adnan H Siddiqui A1 J Mocco YR 2018 UL http://jnis.bmj.com/content/early/2018/06/01/neurintsurg-2018-013771.abstract AB 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.