Basilar tip aneurysm: endovascular treatment with Guglielmi detachable coils--midterm results.

Klein, G; Szolar, Dieter; Leber, K.; Karaic, R.; Hausegger, K. A.

doi:10.1148/radiology.205.1.9314984

Cited by 68 publications

(14 citation statements)

References 21 publications

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“…14 Comparison with other published series of endovascular treatment not limited to the subset of ruptured posterior circulation lesions reveals comparable outcome statistics. 5,[13][14][15][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] These series (Table 2) show GOS I outcome in 44% to 100% of good-grade patients, with a mean of 79%.…”

Section: Clinical Outcomesmentioning

confidence: 92%

Endovascular Treatment of Ruptured Posterior Circulation Cerebral Aneurysms

Lempert

Malek

Halbach

et al. 2000

Stroke

139

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Background and Purpose —We sought to describe the clinical outcome and angiographic results obtained in the endovascular therapy of ruptured posterior circulation cerebral aneurysms using Guglielmi detachable coils (GDC) over a 7-year period. Methods —A retrospective analysis was performed of 112 patients evaluated at the University of California at San Francisco Medical Center between June 1991 and August 1998. The Hunt-Hess grade at presentation of treated patients was I in 26 patients (24%), II in 24 (22%), III in 27 (25%), IV in 24 (22%), and V in 8 (7%). Clinical follow-up for the total population was achieved in 104 of 109 patients (96%), with a mean duration of 13.1 months. Angiographic follow-up for the subset excluding parent vessel occlusion cases was obtained in 93% of cases, with a mean duration of 7.2 months. Results —Technical success, defined as the ability to catheterize and embolize the aneurysm with GDC, was achieved in 109 of 112 of cases (97%). The mean angiographic occlusion rate, or projected area of the aneurysm occluded by the coils, for all 110 successfully treated aneurysms was 94.6%. At latest clinical follow-up, 81 of 109 patients (74%) achieved good recovery with Glasgow Outcome Scale (GOS) score of I, 10 of 109 (9%) were moderately (GOS II) and 5 of 109 (5%) were severely (GOS III) disabled, 1 of 109 (1%) remained in a vegetative state (GOS IV), and 12 of 109 (11%) were dead. Of the subset of 77 patients with Hunt-Hess grades I to III, 68 (88%) achieved a good clinical outcome (GOS I). A statistically significant correlation was demonstrated between Hunt-Hess grade at presentation and final GOS outcome score (χ 2 =41.4, P <0.0005). Procedure-related permanent morbidity was 2.8% (3/109 patients). Repeated hemorrhage was observed in a single patient (0.9%) with a partially treated aneurysm. Conclusions —The observed favorable outcome and low morbidity in this group of high-risk patients point to GDC embolization as an effective method for the endovascular management of patients with ruptured posterior circulation aneurysms.

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Section: Clinical Outcomesmentioning

confidence: 92%

Endovascular Treatment of Ruptured Posterior Circulation Cerebral Aneurysms

Lempert

Malek

Halbach

et al. 2000

Stroke

139

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“…25 Table 10 summarizes the data from six such studies. 1,15,22,27,32,34 In a systematic review of five published articles, Lozier and colleagues 25 collected data on the indications for endovascular therapy of 182 BA apex aneurysms. In 50.5% of the pa- (7) 7 (3) 0 (0) 0 (0) mild permanent deficit due to coil treatment 7 (7) 1 (0.5) 0 (0) 0 (0) severe permanent deficit due to coil treatment 3 (3) 6 (3) 0 (0) 2 (7) death due to coil treatment 2 (2) 5 (2) 0 (0) 0 (0) preexisting deficit 12 (11) 8 (4) 6 (32) 1 (3) mild permanent deficit independent of 8 (8) 7 (3) 2 (11) 0 (0) endovascular treatment severe permanent deficit independent of 4 (4) 28 (14) 1 (5) 2 (7) endovascular treatment death independent of endovascular treatment 1 (1) 13 (6) 0 (0) 0 (0) noncoil procedure-related severe permanent deficit 1 (1) 0 (0) 0 (0) 0 (0) * Clinical outcome data unavailable for three ruptured lesions.…”

Section: Endovascular Coil Occlusion Of Ba Tip Aneurysmsmentioning

confidence: 99%

Angiographic and clinical results in 316 coil-treated basilar artery bifurcation aneurysms

Henkes¹,

Fischer²,

Mariushi³

et al. 2005

Journal of Neurosurgery

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“…5,8,10,12 Two of 6 studies reported the incidence of hydrocephalus (29 of 76 patients; 38.2%). 10,11 Only 1 study mentioned the occurrence of 2 medical complications (nonfatal pulmonary embolism and fatal renal failure). 9…”

Section: Baseline Characteristics: Basilar Apexmentioning

confidence: 99%

“…The most accessible data arose from articles that presented tables listing the baseline characteristics, initial and follow-up angiographic occlusion percentages, complications, and clinical outcome measures for individual patients. 2,10,11,18 Other studies provided tables, charts, or text descriptions of subsets of the cohort from which data were extracted with varying degrees of difficulty. 1,8,9,12,[15][16][17] Data regarding aneurysm occlusion on initial and postoperative angiograms were often presented in such a way that it was difficult or impossible to track the fate of an individual aneurysm.…”

Section: Data Accessibility and Data Qualitymentioning

confidence: 99%

Guglielmi Detachable Coil Embolization of Posterior Circulation Aneurysms

Lozier

Connolly

Lavine

et al. 2002

Stroke

105

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Background-Early multicenter trials of Guglielmi detachable coil embolization of posterior circulations aneurysms have been followed by the publication of numerous single-center experiences. Summary of Review-We performed a MEDLINE literature search and extracted data from single-center reports containing at least 10 posterior circulation aneurysms. Twelve reports (495 aneurysms) were specific to the posterior circulation. Eighty-two percent of aneurysms arose near the basilar apex. Eighty-one percent of patients harbored unruptured aneurysms or presented in good clinical condition. Sixty-three percent of lesions were small, and 41% exhibited a narrow neck. Coil deposition was achieved in 97.6% of cases. Procedural complication and morbidity rates were 12.5% and 5.1%, respectively. Procedural and 30-day mortality rates were 1.4% and 6.7%, respectively. Complete aneurysm occlusion was achieved in 47.6%, near-complete occlusion (90% to 99%) in 43.4%, and incomplete occlusion in 9.0% of cases. There were a total of 52 recurrences (22.2%) in a subset of 234 evaluable patients. Ninety-two percent of these aneurysms exhibited wide necks. The annual risk of subarachnoid hemorrhage after embolization was 0.8%. Eighty-five percent of patients achieved functional independence, while only 5.3% lived dependent lifestyles. The overall mortality rate was 9.8%. Conclusions-The

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Basilar tip aneurysm: endovascular treatment with Guglielmi detachable coils--midterm results.

Abstract: Endovascular treatment of a basilar tip aneurysm with Guglielmi detachable coils seems to be a safe and less invasive alternative to surgical clipping.

Cited by 68 publications

References 21 publications

Endovascular Treatment of Ruptured Posterior Circulation Cerebral Aneurysms

Endovascular Treatment of Ruptured Posterior Circulation Cerebral Aneurysms

Angiographic and clinical results in 316 coil-treated basilar artery bifurcation aneurysms

Guglielmi Detachable Coil Embolization of Posterior Circulation Aneurysms

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