Intracranial aneurysm embolization using Penumbra fill and finish coils: 1-year results of a prospective, real-world, multicenter SURF study
Bibliographic record
Abstract
BACKGROUND: SURF was a prospective, multicenter, single-arm, observational study with core lab adjudication of radiographic data, assessing embolization of intracranial aneurysms (IAs) using WAVE Extra Soft Coils as part of SMART Coil System. METHODS: 75% of implanted coils and WAVE as the final finishing coil were enrolled at 43 global centers. Primary outcomes were adequate occlusion (Raymond-Roy Occlusion Classification, RROC I/II) at 1 year, serious adverse events (SAEs) within 24 hours, and device-related SAEs up to 7 days (or discharge). RESULTS: A total of 572 patients (mean age 59.5 years, 72.6% female) were enrolled between November 2019 and August 2022. Among target IAs, 39.9% were ruptured, 78.7% saccular, 54.1% wide-necked, and 11.2% previously treated, with 37.1% located in the internal carotid artery and 30.6% in the anterior cerebral artery. The mean size was 6.6±3.45 mm. Unassisted coiling was used in 50.7% of cases. Adjunctive therapy included stent-assisted coiling (28.8%), balloon-assisted coiling (17.7%), and flow diverters or medications (5.6%). The mean packing density was 34%. RROC I/II was 87.4% immediately post-procedure and 92.4% at 1 year. The retreatment rate was 9.8%, and recanalization was 12.7% at 1 year. SAEs rate within 24 hours was 9.3%. Device-related SAEs occurred in 1.1% of patients. The rate of major ipsilateral stroke was 1.7%. CONCLUSION: Penumbra's WAVE coils resulted in high packing density and effective and durable embolization of IAs in a diverse, real-world population, supporting coiling as the standard of care for IA treatment. TRIAL REGISTRATION NUMBER: NCT04106583.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".