Stroke · 2012 · 120 citations · 16 references
MedicineNeurosurgerySurgeryCerebrovascular SurgeryEvidence-based PracticeVascular SurgeryAneurysm RepairAneurysm SurgeryCerebrovascular DiseaseAneurysm RecanalizationAngiographic SuccessPrimary Outcome AnalysisRandomized Controlled Trial BaselineRuptured Aneurysm ManagementUnruptured Aneurysm ManagementUnruptured Intracranial Aneurysm Management
BACKGROUND AND PURPOSE: We report the primary outcome of the Cerecyte Coil Trial, a randomized trial to determine whether polymer-loaded Cerecyte coils compared with Micrus bare platinum coils improved the proportion of patients with angiographic occlusion of the aneurysm at 6 months when assessed by a core laboratory. The secondary objectives were to compare the clinical outcomes and retreatment rates in the 2 groups. METHODS: Five hundred patients between 18 and 70 years of age with a ruptured or unruptured target aneurysm were randomized to be treated with either Cerecyte or bare platinum coils in 23 centers worldwide. Two hundred forty-nine patients were assigned to Cerecyte coils and 251 to bare platinum coils. Analysis was by intention to treat. RESULTS: Four hundred ninety-four patients were eligible for analysis. Four hundred eighty-one patients underwent coil treatment of their aneurysm, 227 patients with recently ruptured aneurysms and 254 with unruptured aneurysms. Four hundred thirty-three follow-up angiograms were assessed by the core laboratory; 127 of 215 (59%) and 118 of 218 (54%) in the Cerecyte and bare platinum groups, respectively, fulfilled the trial prespecified definition of success, namely that the treated aneurysm showed complete angiographic occlusion, had stable neck remnant, or improved in angiographic appearance compared with the end-of-treatment angiogram (P=0.17). Late retreatment was performed in 25 of 452 (5.5%) patients, 17 (7.7%) Cerecyte versus 8 (3.5%) bare platinum (P=0.064; range, 4-34 months). The clinical outcomes did not differ between the groups. CONCLUSIONS: There was no significant difference at 6 months in the angiographic outcomes between Cerecyte coils and bare platinum coils when assessed by the core laboratory. Clinical Trial Registration Information- URL: www.controlled-trials.com. Unique Identifier: ISRCTN82461286.
16
Andrew Molyneux, Richard Kerr, Ly‐Mee Yu et al. · The Lancet · 2005 · 2.9K citations
Medicine, Neurosurgery, Surgery +17
Endovascular Treatment of Unruptured Aneurysms
Daniel Roy, Geneviève Milot, Jean Raymond · Stroke · 2001 · 961 citations · Full text
Medicine, Neurosurgery, Surgery +17
Andrew Molyneux, Richard Kerr, Jacqueline Birks et al. · The Lancet Neurology · 2009 · 906 citations · Full text
Medicine, Neurosurgery, Surgery +17
The Barrow Ruptured Aneurysm Trial
Cameron G. McDougall, Robert F. Spetzler, Joseph M. Zabramski et al. · Journal of neurosurgery · 2011 · 641 citations
Predictors of Rehemorrhage After Treatment of Ruptured Intracranial Aneurysms
S. Claiborne Johnston, Christopher F. Dowd, Randall T. Higashida et al. · Stroke · 2007 · 499 citations · Full text
Medicine, Neurosurgery, Surgery +16