Coiling of Ruptured Tiny Cerebral Aneurysms, Feasibility, Safety, and Durability at Midterm Follow-Up, and Individual Experience

Mansour, Ossama Yassin; Megahed, Mustafa; Schumacher, M.; Weber, Johannes; Khalil, Mohamed A.

doi:10.1007/s00062-012-0182-x

Cited by 5 publications

(3 citation statements)

References 23 publications

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“…In our institution, small cerebral aneurysm recurrences with sizes of 7 mm or less that require additional treatment, which was included in the study criteria, were defined as cases where contrast filling of more than 2 mm of the residual aneurysm was observed. It was judged that 2 mm was the minimum size that could be filled using one minimum size coil 12,17,30) . Of the 19 recurrence cases, six cases (31.6%) showed repeated recurrence due to coil mesh compaction even after additional treatment and for this, additional coil embolization was repeatedly performed.…”

Section: Discussionmentioning

confidence: 99%

Angiographic Follow-Up for Small Ruptured Intracranial Aneurysm Treated by Endovascular Treatment : Follow-Up Plan and Long-Term Follow-Up Results

Kim

Chung

2022

J Korean Neurosurg Soc

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Objective : Although endovascular treatment for intracranial aneurysms is considered effective and safe, its durability is still debated. Also, few studies have described angiographic follow-up plan after endovascular treatment of intracranial aneurysm, especially in ruptured cases. Hence, we report the long-term results of follow-up angiography protocol. Methods : Radiological records of 639 cases of coil embolization with ruptured aneurysms from March 2003 to December 2016 were retrospectively reviewed. Patients who received treatment of a saccular aneurysm less than 7 mm resulted with near complete occlusion were included. Two hundred thirty-eight aneuryms which received the follow-up angiography at least once were enrolled. We classified four periods of follow-up as follows : post-treatment 1 year (defined as the first period), from 1 to 2 years (the second period), 2 to 5 years (the third period), and over 5 years (long-term). Results : We identified 14 cases (6.4%) of recurrence from 218 aneurysms in follow-up angiography in the first period. Among 143 aneurysms in the second period, five cases (3.5%) of recurrence were identified. There were no findings suspicious of recanalization in 97 patients in the third period. Of the total 238 cases, there were 19 recurrences, for a recurrence rate of 8.0%. Six (31.6%) out of 19 recurrences showed a tendency toward repeat recurrences even after additional treatment. Twenty-eight received long-term follow-up over 5 years and there was no recurrence. Conclusion : Most of the recurrence were found during the first and the second year. We suggest that at least one digital subtraction angiography examination may be necessary around post-treatment 2 years, especially in ruptured cases. If the angiographic results are favorable at 2 years post-treatment, long-term result should be favorable.

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Section: Discussionmentioning

confidence: 99%

Angiographic Follow-Up for Small Ruptured Intracranial Aneurysm Treated by Endovascular Treatment : Follow-Up Plan and Long-Term Follow-Up Results

Kim

Chung

2022

J Korean Neurosurg Soc

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“…In the case of a tiny aneurysm both surgical clipping and endovascular embolization are highly difficult due to their size and thin walls with most presenting with a wide neck [5,15,16] and are also associated with morbidity [17][18][19]. In the case of surgical clipping, the tiny size of the aneurysm makes it difficult to clip firmly.…”

Section: Introductionmentioning

confidence: 99%

Single coil endovascular embolization of very tiny (≤2 mm) intracranial aneurysms: one center's experience

Yao¹,

Bai²,

Li³

et al. 2022

J. Integr. Neurosci.

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Background: To investigate the safety and e ficacy of endovascular embolization of very tiny (≤2 mm) intracranial aneurysms with single coil and summarize experience. Methods: A retrospective analysis was performed for 15 consecutive patients with very tiny aneurysms treated by coil embolization alone or stent-assisted coil embolization between January 2017 and January 2020. 15 patients with six unruptured aneurysms and nine ruptured aneurysms were included in this study. There were eight males and seven females with a mean age of 50.0 ± 5.2 years (range 41 to 57 years old). Intraoperative complications, imaging outcomes, clinical outcomes and follow-up data were analyzed. Results: All aneurysms were embolized with a single coil. Lvis stents were used in all coil assisted embolizations. The embolization success rate was 100%. The average volume embolization ratio (VER) of aneurysm embolization was 53.7 ± 25.5%. An intraoperative aneurysm re-rupture complication occurred in one patient (6.7%). 11 patients (73.3%) had immediate complete occlusion a ter embolization. A ter a mean follow-up period of 6.7 ± 1.4 months, 13 patients (86.7%) had complete occlusion. No patients had aneurysm re-rupture, an ischemic event or recurrence during follow-up. All patients achieved favorable clinical outcomes with a modified rankin scale (MRS) of 0-2. Conclusions: This study demonstrates that endovascular embolization of very tiny intracranial aneurysms with a single coil is safe and e fective. However, the follow-up period was not long enough and studies with larger numbers of patients are required. The summary of experience reported here is expected to provide significant patient benefits.

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“…This has made the use of BACE a more prevalent and preferable approach by clinicians in the last several years to treat wide-necked intracranial aneurysms [3,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. Balloons have also been shown to help in the tamponade of the vessel in case of intraoperative perforation [22,23] and are also used for occlusion testing before sacrifice of the vessel. Previously, Lubicz et al [8], Mu et al [15], Youn et al [16] and Cekirge et al [17 ]reported the use of a super-compliant balloon (HyperForm) in the treatment of wide-necked aneurysms located on arterial bifurcations and/or small arteries.…”

Section: Introductionmentioning

confidence: 99%

Early Experience with the TransForm™ Occlusion Balloon Catheter: A Single-Center Study

et al. 2014

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Background and Objective: Balloon-assisted coil embolization has become an important adjunct in the endovascular treatment of intracranial aneurysms. The management of broad-necked cerebral aneurysms is technically perplexed due to a variety of factors, which include the difficulty in defining the aneurysm-parent vessel interface angiographically and problems in achieving complete aneurysmal occlusion. This could later predispose to regrowth or recanalization. We sought to determine the safety and efficacy of the TransForm™ occlusion balloon catheter (TOBC) for the coiling of intracranial aneurysms at our institute. Methods: A retrospective review was performed to identify TOBC cases between May 1, 2013, and April 30, 2014. Results: A total of 24 TOBC cases were identified. In 23 cases, the TOBC was used for balloon-remodeled coil embolization, and in 1 case, it was used for vasospasm treatment alone. Out of the total 24 cases in which the TOBC was used, 16 (66.6%) were ruptured aneurysms. Stents were used in 6/23 (26%) cases. In all cases, the balloon could be placed as intended. The inflation and deflation times ranged from 3 to 4 s. No serious complications were noted. In the experience of the authors, the balloon performed the intended role in most cases. Conclusions: This series shows that the TOBC is feasible, safe and useful in the treatment of cerebral aneurysms. The balloon was traceable to the intended site and the preparation, inflation and deflation times were short. We believe that the TOBC has effective utility in treating broad-necked and small aneurysms.

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Coiling of Ruptured Tiny Cerebral Aneurysms, Feasibility, Safety, and Durability at Midterm Follow-Up, and Individual Experience

Abstract: Coil embolization of tiny ruptured cerebral aneurysms is feasible. Careful consideration of the technical issues in treatment of such aneurysms is essential to achieve technical success while avoiding complications.

Cited by 5 publications

References 23 publications

Angiographic Follow-Up for Small Ruptured Intracranial Aneurysm Treated by Endovascular Treatment : Follow-Up Plan and Long-Term Follow-Up Results

Angiographic Follow-Up for Small Ruptured Intracranial Aneurysm Treated by Endovascular Treatment : Follow-Up Plan and Long-Term Follow-Up Results

Single coil endovascular embolization of very tiny (≤2 mm) intracranial aneurysms: one center's experience

Early Experience with the TransForm™ Occlusion Balloon Catheter: A Single-Center Study

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