%0 Journal Article %A Reade A De Leacy %A Kyle M Fargen %A Justin R Mascitelli %A Johanna Fifi %A Lena Turkheimer %A Xiangnan Zhang %A Aman B Patel %A Matthew J Koch %A Aditya S Pandey %A D Andrew Wilkinson %A Julius Griauzde %A Robert F James %A Enzo M Fortuny %A Aurora Cruz %A Alan Boulos %A Emad Nourollah-Zadeh %A Alexandra Paul %A Eric Sauvageau %A Ricardo Hanel %A Pedro Aguilar-Salinas %A Roberta L Novakovic %A Babu G Welch %A Ranyah Almardawi %A Gaurav Jindal %A Harish Shownkeen %A Elad I Levy %A Adnan H Siddiqui %A J Mocco %T 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) %D 2019 %R 10.1136/neurintsurg-2018-013771 %J Journal of NeuroInterventional Surgery %P 31-36 %V 11 %N 1 %X 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. %U https://jnis.bmj.com/content/neurintsurg/11/1/31.full.pdf