TY - JOUR 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 SP - 31 LP - 36 DO - 10.1136/neurintsurg-2018-013771 VL - 11 IS - 1 AU - Reade A De Leacy AU - Kyle M Fargen AU - Justin R Mascitelli AU - Johanna Fifi AU - Lena Turkheimer AU - Xiangnan Zhang AU - Aman B Patel AU - Matthew J Koch AU - Aditya S Pandey AU - D Andrew Wilkinson AU - Julius Griauzde AU - Robert F James AU - Enzo M Fortuny AU - Aurora Cruz AU - Alan Boulos AU - Emad Nourollah-Zadeh AU - Alexandra Paul AU - Eric Sauvageau AU - Ricardo Hanel AU - Pedro Aguilar-Salinas AU - Roberta L Novakovic AU - Babu G Welch AU - Ranyah Almardawi AU - Gaurav Jindal AU - Harish Shownkeen AU - Elad I Levy AU - Adnan H Siddiqui AU - J Mocco Y1 - 2019/01/01 UR - http://jnis.bmj.com/content/11/1/31.abstract N2 - 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. ER -