{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T15:59:44Z","timestamp":1762444784811},"reference-count":25,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J NeuroIntervent Surg"],"accepted":{"date-parts":[[2018,4,4]]},"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Intracranial aneurysm recanalization after endovascular treatment (EVT) remains a major problem. The goal of this study was to find new predictive factors of recanalization after EVT of middle cerebral artery (MCA) bifurcation aneurysms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>96 MCA bifurcationaneurysms, ruptured or unruptured, treated by EVT between Septembre 2009 and December 2014, were retrospectively included. Clinical parameters and aneurysm characteristics were recorded. From the initial three-dimensional DSA, spatial coordinates found on parent and daughter arteries of MCA bifurcations gave four different flow angle values; inflow, outflows 1 and 2, and the global outflow angle (the sum of the two outflow angles). Inter- and intra-observer reproducibilities of three-dimensional angle value measurements were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recanalization occurred in 25 cases (26%) and retreatment was performed in 11 cases (11%). Only 1 patient (1%) had rebleeding. Univariate analysis established the following as predictive factors of recanalization: high blood pressure (P=0.014), aneurysm height (P&lt;0.001), aneurysm width (P&lt;0.001), neck size (P&lt;0.001), postoperative occlusion class (P=0.040), percentage of packing volume (P&lt;0.001), as well as the two outflow angles (P=0.006\u2009and 0.045), and the global outflow angle (P&lt;0.001). Multivariate analysis revealed two independent risk factors for recanalization: the global outflow angle (OR=1.05; 95%\u2009CI 1.02 to 1.08; P&lt;0.002) and aneurysm width (OR=0.67; 95%\u2009CI 0.46 to 0.96; P=0.031). A global outflow angle threshold &lt;192\u00b0 was found to be a risk factor for recanalization (OR=13.75; 95%\u2009CI 4.46 to 42.44), with a sensitivity of 80% and specificity of 77%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study emphasizes that a new parameter, the global outflow angle, can be predictive of recanalization for MCA bifurcation aneurysms treated by EVT.<\/jats:p><\/jats:sec>","DOI":"10.1136\/neurintsurg-2018-013803","type":"journal-article","created":{"date-parts":[[2018,5,25]],"date-time":"2018-05-25T16:25:15Z","timestamp":1527265515000},"page":"1174-1178","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Impact of the global outflow angle on recanalization after endovascular treatment of middle cerebral artery bifurcation aneurysms"],"prefix":"10.1136","volume":"10","author":[{"given":"Yannick","family":"de La 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