1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [83044bd1-0012-4bcf-bbdc-6cacd509320d] => Array
        (
            [runtime-id] => 83044bd1-0012-4bcf-bbdc-6cacd509320d
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => Controlled
            [privilege] => Array
                (
                    [fa3092c4-ead2-4149-9986-3b987ed51064] => Array
                        (
                            [runtime-id] => fa3092c4-ead2-4149-9986-3b987ed51064
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;1f09a7f9a2cc98a7dcdb2c1dc84f554a3969d701
                )

        )

)
1naresh2naresh<pre>Array
(
    [urn:ac.highwire.org:guest:identity] => Array
        (
            [runtime-id] => urn:ac.highwire.org:guest:identity
            [type] => guest
            [service-id] => ajnr-ac.highwire.org
            [access-type] => OpenAccess
            [privilege] => Array
                (
                    [urn:ac.highwire.org:guest:privilege] => Array
                        (
                            [runtime-id] => urn:ac.highwire.org:guest:privilege
                            [type] => privilege-set
                            [privilege-set] => GUEST
                        )

                )

            [credentials] => Array
                (
                    [method] => guest
                )

        )

    [d002e127-3a8a-4ab1-b551-ad9bae08273a] => Array
        (
            [runtime-id] => d002e127-3a8a-4ab1-b551-ad9bae08273a
            [type] => toll-free-key
            [service-id] => ajnr-ac.highwire.org
            [access-type] => OpenAccess
            [privilege] => Array
                (
                    [8a7586c3-49e9-4e77-99b5-0a442dac0b96] => Array
                        (
                            [runtime-id] => 8a7586c3-49e9-4e77-99b5-0a442dac0b96
                            [type] => toll-free-key
                        )

                )

            [credentials] => Array
                (
                    [method] => toll-free-key
                    [value] => tf_ipsecsha;1f09a7f9a2cc98a7dcdb2c1dc84f554a3969d701
                )

        )

)
RT Journal Article
SR Electronic
T1 Stent-Assisted Coiling in the Treatment of Unruptured Intracranial Aneurysms: A Randomized Clinical Trial
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
DO 10.3174/ajnr.A7815
A1 Boisseau, W.
A1 Darsaut, T.E.
A1 Fahed, R.
A1 Drake, B.
A1 Lesiuk, H.
A1 Rempel, J.L.
A1 Gentric, J.-C.
A1 Ognard, J.
A1 Nico, L.
A1 Iancu, D.
A1 Roy, D.
A1 Weill, A.
A1 Chagnon, M.
A1 Zehr, J.
A1 Lavoie, P.
A1 Nguyen, T.N.
A1 Raymond, J.
YR 2023
UL http://www.ajnr.org/content/early/2023/03/16/ajnr.A7815.abstract
AB BACKGROUND AND PURPOSE: Stent-assisted coiling may improve angiographic results of endovascular treatment of unruptured intracranial aneurysms compared with coiling alone, but this has never been shown in a randomized trial.MATERIALS AND METHODS: The Stenting in the Treatment of Aneurysm Trial was an investigator-led, parallel, randomized (1:1) trial conducted in 4 university hospitals. Patients with intracranial aneurysms at risk of recurrence, defined as large aneurysms (≥10 mm), postcoiling recurrent aneurysms, or small aneurysms with a wide neck (≥4 mm), were randomly allocated to stent-assisted coiling or coiling alone. The composite primary efficacy outcome was “treatment failure,” defined as initial failure to treat the aneurysm; aneurysm rupture or retreatment during follow-up; death or dependency (mRS &gt; 2); or an angiographic residual aneurysm adjudicated by an independent core laboratory at 12 months. The primary hypothesis (revised for slow accrual) was that stent-assisted coiling would decrease treatment failures from 33% to 15%, requiring 200 patients. Primary analyses were intent to treat.RESULTS: Of 205 patients recruited between 2011 and 2021, ninety-four were allocated to stent-assisted coiling and 111 to coiling alone. The primary outcome, ascertainable in 203 patients, was reached in 28/93 patients allocated to stent-assisted coiling (30.1%; 95% CI, 21.2%–40.6%) compared with 30/110 (27.3%; 95% CI, 19.4%–36.7%) allocated to coiling alone (relative risk = 1.10; 95% CI, 0.7–1.7; P = .66). Poor clinical outcomes (mRS &gt;2) occurred in 8/94 patients allocated to stent-assisted coiling (8.5%; 95% CI, 4.0%–16.6%) compared with 6/111 (5.4%; 95% CI, 2.2%–11.9%) allocated to coiling alone (relative risk = 1.6; 95% CI, 0.6%–4.4%; P = .38).CONCLUSIONS: The STAT trial did not show stent-assisted coiling to be superior to coiling alone for wide-neck, large, or recurrent unruptured aneurysms.CAcoiling aloneDSMCData and Safety Monitoring CommitteeRRrelative riskSACstent-assisted coilingUIAunruptured intracranial aneurysm