1. Risk factors for Complications In Ruptured Aneurysms Embolization Clarity Study : 782 Patients L. Pierot, C. Cognard, R. Anxionnat, F. Ricolfi, et investigateurs CLARITY What are the factors influencing the risk of Thrombo-embolic Events (TE) And Intra-operative Rupture (IOR)

2. Clarity Study 19 French Centers19 French Centers Oct. 2006 /Jul. 2007Oct. 2006 /Jul. 2007 405 coiled patients405 coiled patients 16 French Centers16 French Centers Apr. 07 /July 08Apr. 07 /July 08 377 coiled patients377 coiled patients GDCMatrix

3. Clarity GDC/Matrix: Results Female: 56%Female: 56% Mean age: 51 YMean age: 51 Y Hypertension: 29%Hypertension: 29% Smokers: 47%Smokers: 47% WFNSIIIIIIIVV GDC44.2%21.5%3.7%16.3%14.3% Matrix48.5%22.0%3.4%13.3%12.7% Female: 63.7%Female: 63.7% Mean age: 51 YMean age: 51 Y Hypertension: 23.6%Hypertension: 23.6% Smokers: 33.2%Smokers: 33.2% WFNS 3 to 5: ISAT: 12 % Clarity GDC: 34.5% Clarity Matrix: 29.5%

4. Thromboembolic complications: GDC 405 cases Matrix 377 cases Total 782 cases 54/405 (13.3%) 44/377 (11.7%) 98 (12.5%) No clinical change 31 7.7% 18 4.8% 49 6.3% Transient deficit6 1.5% 13 3.4% 19 2.4% Permanent deficit 13 3.2% 10 2.7% 23 (2.9%) Death4 1% 3 0.8% 7 (0.9%)

5. Intraoperative rupture: GDC 405 cases Matrix 377 cases Total 782 cases 15/405 (3.7%) 19/377 (5 %) 34 (4.3%) No clinical change 12 3% 12 3.2% 24 3.1% Transient deficit1 0.2% 4 1.1% 5 0.6% Permanent deficit 2 0.5% 3 0.8% 5 0.6% Death000

6. Statistical Analysis Uni and Multivariate AnalysisUni and Multivariate Analysis Risk and Morbi-mortality:Risk and Morbi-mortality: –Thrombo-Embolic Complications (TE) –Intra-Operative Rupture (IOR) Regarding:Regarding: –Clinical Factors: Age, sexe, smoking, AHT, WFNS –Anatomical Factors: Location, Size, Neck –Technical Factors (Balloons)

7. TE Risk: Smoking P = 0,015

8. TE Risk: Aneurysm Size P < 0,001

9. TE Risk: Neck Size P = 0,004

10. TE Morbi-Mortality: Aneurysm Size P = 0,007

11. TE Morbi-Mortality: Neck Size P = 0,035

12. TE: MCA/ Other locations Risk of TE P = 0,139 MM of TE P = 0,038

13. TE: Multivariate Analysis Risk of TE:Risk of TE: –Smoking: p=0.024 –Aneurysm Size > 10: p=0.003 Morbimortality:Morbimortality: –Aneurysm Size > 10: p=0.018

14. Risk of IOR: Age P = 0,032

15. Risk of IOR P = 0,017

16. Risk of IOR Aneurysm Location P = 0,061

17. Risk of IOR Aneurysm Size No difference

18. IOR: MCA/ Other locations Risk of IOR P = 0,029 MM of IOR P = 0,112

19. Conclusions Risk factors for TE:Risk factors for TE: –Smoking –Aneurysm Size > 10mm –Neck Size > 4 mm –MCA/ Other locations Risk factors for IOR:Risk factors for IOR: –Absence of arterial Hypertension (?) –Age (?) –MCA/ Other locations

20. Thank You

21. Anévrismes / Modalités traitement Localisation:Localisation: –ACA, AcoA: 396 (50.6%) –ACI: 211 (27.0%) –ACM: 106 (13.6%) –VB: 69 (8.8%) Taille anévrisme:Taille anévrisme: –<= 10: 700 (89.5%) – < 10: 82 (10.5%) Taille collet: –<= 4: 662 (84.7%) –> 4: 120 (15.3%) Modalités traitement: –Coiling: 608 (77.7%) –Remodelling: 160 (20.5%) –Stenting: 14 (1.8%)