@article {Pierot918, author = {Laurent Pierot and Coralie Barbe and Denis Herbreteau and Jean-Yves Gauvrit and Anne-Christine Januel and Fouzi Bala and Fr{\'e}d{\'e}ric Ricolfi and Hubert Desal and St{\'e}phane Velasco and Mohamed Aggour and Emmanuel Chabert and Jacques Sedat and Denis Trystram and Gaultier Marnat and Sophie Gallas and Georges Rodesch and Fr{\'e}d{\'e}ric Claren{\c c}on and Chrysanthi Papagiannaki and Phil White and Laurent Spelle}, editor = {,}, title = {Immediate post-operative aneurysm occlusion after endovascular treatment of intracranial aneurysms with coiling or balloon-assisted coiling in a prospective multicenter cohort of 1189 patients: Analysis of Recanalization after Endovascular Treatment of i{\textellipsis}}, volume = {13}, number = {10}, pages = {918--923}, year = {2021}, doi = {10.1136/neurintsurg-2020-017012}, publisher = {British Medical Journal Publishing Group}, abstract = {Background Coiling, including balloon-assisted coiling (BAC), is the first-line therapy for ruptured and unruptured aneurysms. Its efficacy can be clinically evaluated by bleeding/rebleeding rate after coiling, and anatomically evaluated by aneurysm occlusion post-procedure and during follow-up. We aimed to analyze immediate post-coiling aneurysm occlusion and associated factors within the Analysis of Recanalization after Endovascular Treatment of intracranial Aneurysm (ARETA) population.Methods Between December 2013 and May 2015, 16 neurointerventional departments prospectively enrolled participants treated for ruptured and unruptured aneurysms (ClinicalTrials.gov: NCT01942512). Participant demographics, aneurysm characteristics, and endovascular techniques were recorded. In patients with aneurysms treated by coiling or BAC, immediate post-operative aneurysm occlusion was independently evaluated by a core lab using a 3-grade scale: complete occlusion, neck remnant, and aneurysm remnant.Results Of 1135 participants (age 53.8{\textpm}12.8 years, 754 women (66.4\%)), 1189 aneurysms were analyzed. Treatment modality was standard coiling in 645/1189 aneurysms (54.2\%) and BAC in 544/1189 (45.8\%). Immediate post-operative aneurysm occlusion was complete occlusion in 57.8\%, neck remnant in 34.4\%, and aneurysm remnant in 7.8\%. Adequate occlusion (complete occlusion or neck remnant) was significantly more frequent in aneurysms with size \<10 mm (93.1\% vs 86.3\%; OR 1.8, 95\% CI 1.1 to 3.2; p=0.02) and in aneurysms with a narrow neck (95.8\% vs 89.6\%; OR 2.5, 95\% CI 1.5 to 4.1; p=0.0004). Patients aged \<70 years had significantly more adequate occlusion (92.7\% vs 87.2\%; OR 1.9, 95\% CI 1.1 to 3.4; p=0.04).Conclusions Immediately after aneurysm coiling, including BAC, adequate aneurysm occlusion was obtained in 92.2\%. Age \<70 years, aneurysm size \<10 mm, and narrow neck were factors associated with adequate occlusion.Trial registration number NCT01942512, http://www.clinicaltrials.gov.Data are available upon reasonable request. Data analyzed during the study are available from the corresponding author by request.}, issn = {1759-8478}, URL = {https://jnis.bmj.com/content/13/10/918}, eprint = {https://jnis.bmj.com/content/13/10/918.full.pdf}, journal = {Journal of NeuroInterventional Surgery} }