Evidence map›Paper›PMID 29871561›Full record

ArticleInterventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences2018

Entry remnants in flow-diverted aneurysms: Does branch geometry influence aneurysm closure?

M Akli Zetchi, Adam A Dmytriw, Albert H Chiu, Brian J Drake, Niki V Alizadeh, Aditya Bharatha, Abhaya V Kulkarni, Thomas R Marotta

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Article in Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
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  3. The Silk Vista Baby - The UK experience.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

M Akli Zetchi1 Neurovascular Program, St. Michael's Hospital, University of Toronto, Toronto, Canada.
Adam A Dmytriw2 Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Canada.
Albert H Chiu4 Neurological Intervention & Imaging Service of Western Australia (NIISwa), Sir Charles Gairdner, Fiona Stanley and Royal Perth Hospitals, Perth, Australia.
Brian J Drake1 Neurovascular Program, St. Michael's Hospital, University of Toronto, Toronto, Canada.
Niki V Alizadeh6 Division of Neurosurgery, Sick Kids Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Canada.
Aditya Bharatha2 Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Canada.
Abhaya V Kulkarni6 Division of Neurosurgery, Sick Kids Research Institute, Hospital for Sick Children, University of Toronto, Toronto, Canada.
Thomas R Marotta2 Department of Medical Imaging, St. Michael's Hospital, University of Toronto, Toronto, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveNumerous studies have suggested a relationship between delayed occlusion of intracranial aneurysms treated with the Pipeline Embolization Device (PED) and the presence of an incorporated branch. However, in some cases, flow diversion may still be the preferred treatment option. This study sought to determine whether geometric factors pertaining to relative size and angulation of branch vessel(s) can be measured in a reliable fashion and whether they are related to occlusion rates.

methodsEighty aneurysms treated at a single neurovascular center from November 2008 to June 2014 were identified. Two blinded raters prospectively reviewed the imaging performed at the time of the procedure and measured the following geometric variables: inflow jet/incorporated branch direction angle and branch artery/ parent artery ratio. Delayed occlusion was defined as the absence of complete aneurysmal occlusion at one year. Analysis was performed using logistic regression and intra-class correlation co-efficient (ICC).

resultsTwenty-four (30%) aneurysms with 28 incorporated branches were identified. A trend toward higher inflow jet/incorporated branch direction angle was found in the group of aneurysms demonstrating delayed occlusion when compared to the group with complete occlusion. ICC revealed high correlation. Overall lower one-year occlusion rates of 53% versus 73% for aneurysms with and without incorporated branches, respectively, were also noted.

conclusionsThe presence of an incorporated branch conferred a 20% absolute risk increase for delayed aneurysmal occlusion. Incorporated branches with a larger angle between the inflow jet and the incorporated branch direction exhibited a trend toward lower occlusion rates. This might be further investigated using a multicenter approach in conjunction with other potentially relevant clinical and angiographic variables.

Indexed as

Blood Vessel ProsthesisAdultAgedAngiography, Digital SubtractionAnticoagulantsEmbolization, TherapeuticFemaleHumansIntracranial AneurysmMaleMiddle AgedNeurosurgical ProceduresRadiography, InterventionalRetrospective StudiesRisk AssessmentTomography, X-Ray ComputedAnticoagulantsflow diversionInterventional neuroradiologyintracranial aneurysmneurosurgeryPipeline Embolization Device

Identifiers

PMID29871561
PMCPMC6259341

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.