Outcome in small aneurysms (&lt;4 mm) treated by endovascular coiling

Lum, Cheemun; Narayanam, Surendra; Silva, Leonardo; Shankar, Jai; Bussiére, Miguel; Santos, Marlise P. dos; Lesiuk, Howard

doi:10.1136/neurintsurg-2011-010047

Cited by 12 publications

(6 citation statements)

References 12 publications

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“…In contrast, Chae et al [19] suggested endovascular coiling of very small aneurysms as an acceptable method with good initial angiographic outcomes, without any procedural morbidity and mortality. Lum et al [20] confirmed this statement in their findings, reporting no significant increment in the IPR rate in very small aneurysms. Our results on the very small aneurysm group were in accordance with these findings.…”

Section: Discussionsupporting

confidence: 77%

Endovascular Treatment of Very Small and Very Large Ruptured Aneurysms of the Anterior Cerebral Circulation: A Single-Center Experience

Mohammadian¹,

Asgari

Sattarnezhad³

et al. 2013

Cerebrovasc Dis

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Introduction: Endovascular treatment of aneurysms has been introduced as a less invasive method for decreasing the rate of aneurysm rerupture and subsequent subarachnoid hemorrhage. The outcome and complication rate for endovascular treatment of very small (≤3 mm) and very large (15-25 mm) intracranial aneurysms has been controversial. Here we report our experience with endovascular coiling of very small and very large ruptured aneurysms of the anterior cerebral circulation. Methods: Patients were included in the study if the maximum dimension of the intracranial ruptured aneurysm was reported to be ≤3 mm or 15-25 mm and if the aneurysm was within the anterior cerebral circulation. The largest dimension was calculated using CT angiography and was confirmed by digital subtraction angiography. Endovascular coiling was performed using Guglielmi detachable coils. All patients underwent follow-up contrast MR angiography every 6 months. Results: A total of 40 cases (18 females and 22 males) were included in this single-center study. Twenty-one very small and 19 very large ruptured aneurysms were analyzed. Preprocedural Hunt and Hess grades were determined. Endovascular coiling was performed successfully in most cases (97.5%), with unsuccessful coiling in 1 patient with a very small ruptured aneurysm. In the very small aneurysm group, the most common location was the anterior communicating artery and, in the large aneurysm group, the most common location was the middle cerebral artery (MCA) bifurcation. The mean follow-up time was 15.08 months (range: 6-30 months). The 6th month modified Rankin scale (mRS) values for very small aneurysm cases were 0 (no symptoms at all) in 16 cases (76.2%) and 1 (no significant disability despite symptoms) in 5 cases (23.80%). For the very large aneurysm cases, the mRS values were 1 in 2 cases (10.5%), 2 in 7 cases (36.8%), 3 in 6 cases (31.6%), 4 in 3 cases (15.8%) and 6 in 1 case (died due to vasospasm 72 h later; 5.2%). The immediate complications that were observed were MCA branch occlusion in 1 very small aneurysm patient and early vasospasms in 3 very large aneurysm patients. The late complication that was observed was recanalization in 1 very small aneurysm case (1/21, 4.76%) and in 5 very large aneurysm cases (5/18, 27.77%). Conclusion: Endovascular treatment of very small aneurysms is an effective method of treatment with acceptable immediate and long-term outcomes. Immediate and long-term complications were more prevalent in very large ruptured aneurysms.

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Section: Discussionsupporting

confidence: 77%

Endovascular Treatment of Very Small and Very Large Ruptured Aneurysms of the Anterior Cerebral Circulation: A Single-Center Experience

Mohammadian¹,

Asgari

Sattarnezhad³

et al. 2013

Cerebrovasc Dis

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“…As in several series, the occurrence of post-embolization recanalization was more frequent in the group of patients with ruptured aneurysms [33,34]. The rate of late recanalization after embolization seems to be comparable to other large series reported in the literature [35,36]. Of the 110 operated patients, we recorded no recanalization on the angiographic CT scan performed at 3 years after the microsurgical treatment.…”

Section: Angiographic Outcomesupporting

confidence: 85%

Multidisciplinary management of intracranial aneurysms: The experience of Lille university hospital center

Aboukaïs¹,

Zaïri²,

Thines³

et al. 2014

Neurochirurgie

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“…We believe that our results do not reflect a difference in endovascular methodology or technical skill at our institution (as conventional coiling methods were used in all cases), but rather are a reflection of advances in endovascular technologies. This is supported by the fact that other groups have begun to report small series with similar more favorable outcomes when attempting treatment of small aneurysms in recent years 6 14 20–26. It is our belief that increased availability of small (<4 mm) three-dimensional coils is the primary reason for decreased morbidity and mortality in the treatment of small aneurysms compared with historical controls.…”

Section: Discussionmentioning

confidence: 81%

Conventional endovascular treatment of small intracranial aneurysms is not associated with additional risks compared with treatment of larger aneurysms

Stetler

Wilson

Al-Holou

et al. 2014

J NeuroIntervent Surg

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Outcome in small aneurysms (<4 mm) treated by endovascular coiling

Cited by 12 publications

References 12 publications

Endovascular Treatment of Very Small and Very Large Ruptured Aneurysms of the Anterior Cerebral Circulation: A Single-Center Experience

Endovascular Treatment of Very Small and Very Large Ruptured Aneurysms of the Anterior Cerebral Circulation: A Single-Center Experience

Multidisciplinary management of intracranial aneurysms: The experience of Lille university hospital center

Conventional endovascular treatment of small intracranial aneurysms is not associated with additional risks compared with treatment of larger aneurysms

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