E-203 The SEASE international registry analysis on the treatment of intracranial aneurysms with incorporated branch using cobalt-chromium 64 wires surpass evolve
Notice bibliographique
Résumé
Introduction The use of the Pipeline Embolization Device for the treatment of intracranial aneurysms (IAs) with incorporated branch has been associated with delayed aneurysmal occlusion. However, there is limited evidence on the effectiveness of cobalt-chromium Surpass Evolve (SE; Stryker) for treating these types of IAs. This study aims to evaluate the efficacy and safety of SE for IAs with incorporated branch, and to compare outcomes between those with branch originating from the neck versus those arising from the sac of the aneurysms. Methods This analysis utilizes data from the Safety and Effectiveness Assessment of the Surpass Evolve (SEASE) registry, comprising retrospective data from 15 academic institutions in North America and Europe. Only IAs with incorporated branch were included in the study. Patient characteristics, angiographic findings, and clinical outcomes were assessed for the overall dataset and stratified based on the location of branch emergence from the aneurysm. Results The study included 67 patients (median [IQR] age: 58 years [51–66 years]) with IAs. Among these, 53 had branches emerging from the sac, while 14 had branches originating from the neck. Demographic characteristics, comorbidities, baseline functional status, and IA features were similar between the two groups (P > 0.05). Most IAs were located in the posterior communicating artery (46.3%), with a median size of 4.35 mm (IQR: 3.12, 6.51). At a median imaging follow-up of 10.5 months (IQR: 6.5–13.1 months), complete occlusion rates were lower in IAs with branch emerging from the sac (60.8%) compared to those with neck-originating branch (92.9%, P = 0.026), with an overall occlusion rate of 67.7%. The fate of the incorporated branch remained patent in 98.2% of cases at last follow-up, with no significant difference between the two groups (P > 0.999). Thromboembolic and hemorrhagic complications, as well as retreatment, were reported in 1.6% and 3.1% of cases, respectively, with no significant differences between the groups. Conclusion The use of SE for IAs with incorporated branch demonstrates acceptable rates of occlusion and a favorable safety profile. Notably, better occlusion rates were observed in IAs with branch originating from the neck compared to those emerging from the sac. These findings underscore the importance of careful consideration regarding branch location prior to SE implantation. Further large-scale studies are warranted to validate these results. Disclosures M. Dibas: None. J. Vivanco-Suarez: None. D. Lopes: 1; C; Mentice. 2; C; Asahi, Stryker, Corindus, Siemens, and Medtronic. 4; C; Syncron, Three Rivers Inc., Q’apel, VIZ.AI, Methinks, Vastrax, Borvo, BendIT, Collavidence, NDI, Prometheus, NextGen, Galaxy, Global Intervention, and Sim&Cure. 6; C; Honoraria: Cerenovus, Medtronic, and Stryker. Advisory Board: INFINITY [trial]. R. Hanel: 1; C; NIH, Interline Endowment, Microvention, Stryker, and CNX. 2; C; Medtronic, Stryker, Cerenovous, Microvention, Balt, Phenox, Rapid Medical, and Q’Apel. 4; C; InNeuroCo, Cerebrotech, eLum, Endostream, Three Rivers Medical Inc., Scientia, RisT, BlinkTBI, and Corindus. 6; C; Advisory board: MiVI, eLum, Three Rivers Medical Inc., Shape Medical, and Corindus. A. Rodriguez-Calienes: None. G. Cortez: None. J. Fifi: 1; C; Viz. 2; C; Penumbra, Stryker, Microvention, and Cerenovus. 4; C; Imperative care and Cerebrotech. A. Devarajan: None. G. Toth: 2; C; Medtronic and Dynamed. T. Patterson: None. D. Altschul: 2; C; Microvention, Stryker, and Von Vascular Inc. V. Pereira: 2; C; Stryker, Medtronic, Penumbra, Neurovasc, and Balt. X. Liu: None. A. Puri: 1; C; Medtronic, Stryker, and Cerenovus. 2; C; Medtronic, Stryker, Cerenovus, Microvention, Agile, Merit, Corindus, Q’apel, Arsenal, and Imperative Care. A. Kühn: None. W. Guerrero: None. P. Khandelwal: 2; C; Stryker and Medtronic. I. Bach: None. P. Kan: 1; C; NIH, Siemens, Joe Niekro, and Medtronic. 2; C; Stryker, Imperative Care, Cerenovus, and Microvention. G. Edhayan: None. M. Martinez-Galdamez: 2; C; Medtronic. C. Given: 2; C; Stryker and Medtronic. B. Gross: 2; C; Medtronic, Microvention, and Stryker. S. Narayanan: 2; C; Cerenovus, MicroVention, Inc. and Imperative Care. M. Galecio-Castillo: None. S. Derakhshani: None. S. Ortega-Gutierrez: 1; C; NIH-NINDS (R01NS127114–01, RO3NS126804–01), Stryker, Medtronic, Microvention, Methinks, Viz.ai. 2; C; Medtronic, Stryker Neurovascular.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,007 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,002 |
| Bibliométrie | 0,003 | 0,004 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».