Angiographic and clinical outcomes of balloon remodeling versus unassisted coil embolization in the ruptured aneurysm cohort of the GEL the NEC study

Guilherme Dabus, Waleed Brinjikji, Arun P. Amar, Josser E.Delgado Almandoz, Orlando M. Diaz, Pascal Jabbour, Ricardo Hanel, Ferdinand Hui, Michael Kelly, Kennith F. Layton, Jeffrey W. Miller, Elad I. Levy, Christopher J. Moran, Dae Chul Suh, Henry Woo, Robbin Sellar, Brian Hoh, Avery Evans, David F Kallmes

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background and purpose GEL THE NEC (GTN) was a multicenter prospective registry developed to assess the safety and efficacy of HydroSoft coils in treating intracranial aneurysms. We compared the angiographic and clinical outcomes of aneurysms treated with balloon assisted coil embolization (BACE) versus unassisted coil embolization (CE) in the ruptured aneurysm cohort. Materials and methods GTN was performed at 27 centers in five countries. Patients aged 21-90 years with a ruptured aneurysm 3-15 mm in size were eligible for enrollment. We analyzed demographics/comorbidities, aneurysm location, and geometry, including maximum diameter, neck size, and dome to neck ratio, immediate and long term angiographic outcomes (graded by an independent core laboratory using the modified Raymond Scale), and procedure related adverse events. Angiographic and clinical outcomes were studied using χ2 and t tests. Results Of the 599 patients in the GTN, 194 met the inclusion criteria. 84 were treated with BACE and 110 with CE. There were more prior smokers in the BACE group (p=0.01). The BACE group also had more vertebrobasilar aneurysms (p=0.006) and a larger mean neck size (p=0.02). More aneurysms were immediately completely occluded in the BACE group (p=0.02) Procedure- related major morbidity and mortality were no different between the techniques (p=0.4 and p=1, respectively). Conclusions In this prospective ruptured aneurysm cohort from the GTN, BACE resulted in greater occlusion rates compared with unassisted CE with similar morbi-mortality.

Original languageEnglish (US)
Pages (from-to)447-451
Number of pages5
JournalJournal of NeuroInterventional Surgery
Volume10
Issue number5
DOIs
StatePublished - Jan 1 2018

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Ruptured Aneurysm
Aneurysm
Neck
Mortality
Intracranial Aneurysm
Registries
Comorbidity
Demography
Morbidity
Safety

Keywords

  • aneurysm
  • balloon
  • coil
  • hemorrhage
  • subarachnoid

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Angiographic and clinical outcomes of balloon remodeling versus unassisted coil embolization in the ruptured aneurysm cohort of the GEL the NEC study. / Dabus, Guilherme; Brinjikji, Waleed; Amar, Arun P.; Almandoz, Josser E.Delgado; Diaz, Orlando M.; Jabbour, Pascal; Hanel, Ricardo; Hui, Ferdinand; Kelly, Michael; Layton, Kennith F.; Miller, Jeffrey W.; Levy, Elad I.; Moran, Christopher J.; Suh, Dae Chul; Woo, Henry; Sellar, Robbin; Hoh, Brian; Evans, Avery; Kallmes, David F.

In: Journal of NeuroInterventional Surgery, Vol. 10, No. 5, 01.01.2018, p. 447-451.

Research output: Contribution to journalArticle

Dabus, G, Brinjikji, W, Amar, AP, Almandoz, JED, Diaz, OM, Jabbour, P, Hanel, R, Hui, F, Kelly, M, Layton, KF, Miller, JW, Levy, EI, Moran, CJ, Suh, DC, Woo, H, Sellar, R, Hoh, B, Evans, A & Kallmes, DF 2018, 'Angiographic and clinical outcomes of balloon remodeling versus unassisted coil embolization in the ruptured aneurysm cohort of the GEL the NEC study', Journal of NeuroInterventional Surgery, vol. 10, no. 5, pp. 447-451. https://doi.org/10.1136/neurintsurg-2017-013326
Dabus, Guilherme ; Brinjikji, Waleed ; Amar, Arun P. ; Almandoz, Josser E.Delgado ; Diaz, Orlando M. ; Jabbour, Pascal ; Hanel, Ricardo ; Hui, Ferdinand ; Kelly, Michael ; Layton, Kennith F. ; Miller, Jeffrey W. ; Levy, Elad I. ; Moran, Christopher J. ; Suh, Dae Chul ; Woo, Henry ; Sellar, Robbin ; Hoh, Brian ; Evans, Avery ; Kallmes, David F. / Angiographic and clinical outcomes of balloon remodeling versus unassisted coil embolization in the ruptured aneurysm cohort of the GEL the NEC study. In: Journal of NeuroInterventional Surgery. 2018 ; Vol. 10, No. 5. pp. 447-451.
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abstract = "Background and purpose GEL THE NEC (GTN) was a multicenter prospective registry developed to assess the safety and efficacy of HydroSoft coils in treating intracranial aneurysms. We compared the angiographic and clinical outcomes of aneurysms treated with balloon assisted coil embolization (BACE) versus unassisted coil embolization (CE) in the ruptured aneurysm cohort. Materials and methods GTN was performed at 27 centers in five countries. Patients aged 21-90 years with a ruptured aneurysm 3-15 mm in size were eligible for enrollment. We analyzed demographics/comorbidities, aneurysm location, and geometry, including maximum diameter, neck size, and dome to neck ratio, immediate and long term angiographic outcomes (graded by an independent core laboratory using the modified Raymond Scale), and procedure related adverse events. Angiographic and clinical outcomes were studied using χ2 and t tests. Results Of the 599 patients in the GTN, 194 met the inclusion criteria. 84 were treated with BACE and 110 with CE. There were more prior smokers in the BACE group (p=0.01). The BACE group also had more vertebrobasilar aneurysms (p=0.006) and a larger mean neck size (p=0.02). More aneurysms were immediately completely occluded in the BACE group (p=0.02) Procedure- related major morbidity and mortality were no different between the techniques (p=0.4 and p=1, respectively). Conclusions In this prospective ruptured aneurysm cohort from the GTN, BACE resulted in greater occlusion rates compared with unassisted CE with similar morbi-mortality.",
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T1 - Angiographic and clinical outcomes of balloon remodeling versus unassisted coil embolization in the ruptured aneurysm cohort of the GEL the NEC study

AU - Dabus, Guilherme

AU - Brinjikji, Waleed

AU - Amar, Arun P.

AU - Almandoz, Josser E.Delgado

AU - Diaz, Orlando M.

AU - Jabbour, Pascal

AU - Hanel, Ricardo

AU - Hui, Ferdinand

AU - Kelly, Michael

AU - Layton, Kennith F.

AU - Miller, Jeffrey W.

AU - Levy, Elad I.

AU - Moran, Christopher J.

AU - Suh, Dae Chul

AU - Woo, Henry

AU - Sellar, Robbin

AU - Hoh, Brian

AU - Evans, Avery

AU - Kallmes, David F

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and purpose GEL THE NEC (GTN) was a multicenter prospective registry developed to assess the safety and efficacy of HydroSoft coils in treating intracranial aneurysms. We compared the angiographic and clinical outcomes of aneurysms treated with balloon assisted coil embolization (BACE) versus unassisted coil embolization (CE) in the ruptured aneurysm cohort. Materials and methods GTN was performed at 27 centers in five countries. Patients aged 21-90 years with a ruptured aneurysm 3-15 mm in size were eligible for enrollment. We analyzed demographics/comorbidities, aneurysm location, and geometry, including maximum diameter, neck size, and dome to neck ratio, immediate and long term angiographic outcomes (graded by an independent core laboratory using the modified Raymond Scale), and procedure related adverse events. Angiographic and clinical outcomes were studied using χ2 and t tests. Results Of the 599 patients in the GTN, 194 met the inclusion criteria. 84 were treated with BACE and 110 with CE. There were more prior smokers in the BACE group (p=0.01). The BACE group also had more vertebrobasilar aneurysms (p=0.006) and a larger mean neck size (p=0.02). More aneurysms were immediately completely occluded in the BACE group (p=0.02) Procedure- related major morbidity and mortality were no different between the techniques (p=0.4 and p=1, respectively). Conclusions In this prospective ruptured aneurysm cohort from the GTN, BACE resulted in greater occlusion rates compared with unassisted CE with similar morbi-mortality.

AB - Background and purpose GEL THE NEC (GTN) was a multicenter prospective registry developed to assess the safety and efficacy of HydroSoft coils in treating intracranial aneurysms. We compared the angiographic and clinical outcomes of aneurysms treated with balloon assisted coil embolization (BACE) versus unassisted coil embolization (CE) in the ruptured aneurysm cohort. Materials and methods GTN was performed at 27 centers in five countries. Patients aged 21-90 years with a ruptured aneurysm 3-15 mm in size were eligible for enrollment. We analyzed demographics/comorbidities, aneurysm location, and geometry, including maximum diameter, neck size, and dome to neck ratio, immediate and long term angiographic outcomes (graded by an independent core laboratory using the modified Raymond Scale), and procedure related adverse events. Angiographic and clinical outcomes were studied using χ2 and t tests. Results Of the 599 patients in the GTN, 194 met the inclusion criteria. 84 were treated with BACE and 110 with CE. There were more prior smokers in the BACE group (p=0.01). The BACE group also had more vertebrobasilar aneurysms (p=0.006) and a larger mean neck size (p=0.02). More aneurysms were immediately completely occluded in the BACE group (p=0.02) Procedure- related major morbidity and mortality were no different between the techniques (p=0.4 and p=1, respectively). Conclusions In this prospective ruptured aneurysm cohort from the GTN, BACE resulted in greater occlusion rates compared with unassisted CE with similar morbi-mortality.

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KW - balloon

KW - coil

KW - hemorrhage

KW - subarachnoid

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