ArticleFrontiers in neurology2022
Safety and Long-Term Efficacy Outcomes for Endovascular Treatment of Wide-Neck Bifurcation Aneurysms of the Middle Cerebral Artery: Insights From the SMART Registry.
Article in Frontiers in neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 9 citations in OpenAlex.
- Evaluating expert decision-pattern alignment in endovascular planning for intracranial aneurysms using a multimodal large language model.Neuroradiology · 2026Article
- Intracranial aneurysm embolization using Penumbra fill and finish coils: 1-year results of a prospective, real-world, multicenter SURF study.Journal of neurointerventional surgery · 2026Observational
- Comparison of flow diverters versus stent-assisted coiling in unruptured anterior circulation bifurcation aneurysms: a two-center, propensity score matched study.Neurosurgical review · 2026Article
- Pipeline embolization device versus Neuroform Atlas stent in the treatment of distal anterior circulation aneurysms: a retrospective cohort study.Quantitative imaging in medicine and surgery · 2025Article
- Are There Left-Right Differences in Ruptured Middle Cerebral Artery Bifurcation Aneurysms? A Single-Center Retrospective Study and Review of the Literature.Asian journal of neurosurgery · 2024Article
- Intrasaccular Treatment of Intracranial Aneurysms: A Comprehensive Review.Journal of clinical medicine · 2024Review
- Microsurgical clipping versus endovascular therapy for treating patients with middle cerebral artery aneurysms presenting with neurological ischemic symptoms.Neurosurgical review · 2024Article
- Clinical Outcomes of Endovascular Coil Embolization for Ruptured Middle Cerebral Artery Aneurysms.Journal of neuroendovascular therapy · 2024Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionWide-necked middle cerebral artery bifurcation aneurysms pose specific challenges to endovascular management. Surgical clipping remains the standard treatment approach for these aneurysms in many centers. While recent data suggests the endovascular treatment may be comparable, a prospective datapoint has been lacking. MATERIALS AND
methodsThe Penumbra SMART registry, a prospective, multi-center, single-arm outcomes registry of Penumbra coil-treated aneurysms, was queried for endovascularly treated MCA bifurcation aneurysms with wide necks (dome:neck ratio <2 or neck >4 mm). Safety and efficacy outcomes were summarized for ruptured and unruptured aneurysms, including rupture, complication rate, and 1-year occlusion outcomes.
resultsSeventy-two aneurysms across 31 sites were enrolled. Of these, a total of 15 presented as ruptured aneurysms. Serious adverse events were reported in 21 (29.2%) of patients, with 8 (11.1%) attributed to the device/procedure. Immediately postoperatively, 75.0% of cases achieved "adequate" Raymond Roy Class I (40.3%) or II (34.7%) occlusion outcomes. Of the 72 patients treated, 60 (83.3%) underwent follow-up angiography at 1 year, and among these, 95.0% had 1-year occlusion outcomes of Raymond Roy Class I (71.7%) or II (23.3%). A total of 6 aneurysms (10.0%) were required or were planned for retreatment at the last follow-up.
conclusionThis study represents the most significant prospective sample of endovascularly treated wide-neck MCA bifurcation aneurysms conducted to date. It supports the safety and efficacy of endovascular treatment of these aneurysms.
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