O-025 Geographical influence on aneurysm treatment outcomes and retreatment rates

Background and Purpose Recent data from HELPS, Cerecyte and MAPS trials demonstrate that aneurysms can be safely and effectively treated using various coils. Comparing outcomes between trials can be difficult due to different trial designs. The very low bleeding or rebleeding rates of treated aneurysms has led most investigators to use angiographic outcomes to compare devices. Angiographic assessments are operator-dependent, potentially affecting trial results. We sought to understand the impact of geography on aneurysm retreatment in patients enrolled in the Matrix and Platinum Science (MAPS) Trial. Materials and Methods Post hoc analysis was performed on MAPS trial data. Patients were stratified into two groups based on treating center location. Centers were categorized as being in North America (NA) or International (INTL). Baseline patient demographics, comorbidities, and aneurysms characteristics that could impact treatment outcomes were analyzed. Procedural complications and clinical and angiographic outcomes were compared. Results 407 patients (115 ruptured, 292 elective) from 28 NA sites and 219 patients (113 ruptured, 140 elective) from 15 INTL sites were evaluated. Patient demographics differed between NA and INTL, with the most significant (p Conclusion Endovascular treatment practices for intracranial aneurysms are very different between NA and INTL sites, likely reflecting practice variation rather than individual patient differences. Retreatment of partially occluded aneurysms tends to occur more frequently in the first year in NA but later elsewhere. This trend has critical value when interpreting trials results that report short-term outcomes. Competing interests C Prestigiacomo: Thermopeutix, Edge Therapeutics, Stryker. J Mocco: None. S Hetts: None. G Nesbit: None. Y Murayama: None. C Macdougall: None. S Johnston: None. G Ge: Stryker Neurovascular. S Jung: Stryker Neurovascular. A Gholkar: None. D Lopes: None. J Perl: None. D Tampieri: None. A Turk: None.