Stand-alone coil embolization of anterior communicating artery aneurysms: Efficacy and technical issues

Kocur, Damian; Zbroszczyk, Miłosz; Przybyłko, Nikodem; Hofman, Mariusz; Jamróz, Tomasz; Baron, Jan; Bazowski, P; Kwiek, S

doi:10.1177/1971400916665388

Cited by 6 publications

(7 citation statements)

References 22 publications

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“…Other manuscripts, on the other hand, reported intraprocedural rupture of aneurysm as the dominating one. The incidence of this complication was frequently linked with overpacking of the aneurysm [14, 30], which is in accordance with our results. Generally, the most common reasons for the intraprocedural rupture mentioned in the literature are: coil oversizing, aneurysm overpacking, excessively stiff coils or incautious manoeuvres of the microcatheter or even the guidewire itself [30].…”

Section: Discussionsupporting

confidence: 92%

“…[31]. Moreover, the mortality rate in our study (25.7%) seems to be relatively high, as in the majority of studies it ranges between 1% and 6.5% [14, 16, 19, 21, 22]. On the other hand, it is worth noting that the lion’s share of deaths during the hospitalization were linked with high Hunt-Hess grade at admission.…”

Section: Discussionsupporting

confidence: 41%

“…In the present study, we achieved the result of complete aneurysm obliteration in 56.9% of treated patients immediately after the procedure, which was a good result in comparison to other listed studies. Only four of them reached higher efficacy in terms of total occlusion, but three of these studies were conducted on notably smaller groups [12, 14, 18] and the remaining one focused mainly on unruptured aneurysms [20]. Furthermore, in contrast to the rate of immediate complete and near-complete occlusion of ACoA aneurysms reported by Fang et al in the meta-analysis (88%), our results (94.5%) still remain favourable [23].…”

Section: Discussionmentioning

confidence: 99%

“…Our results confirmed that high value of packing density was a predisposing factor of coil prolapse as well. Nevertheless, it is a rather harmless complication, since minor coil displacements into the vessel lumen, without any evidence of flow disruption or thrombosis, could even be treated conservatively using anti-platelet and anti-coagulant agents [14].…”

Section: Discussionmentioning

confidence: 99%

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Angiographic and clinical results of anterior communicating artery aneurysm endovascular treatment.

Brzegowy¹,

Kucybała²,

Krupa³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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IntroductionThe anterior communicating artery (ACoA) is the most common location of intracranial aneurysms, observed in 35% of cases. Endovascular treatment has become an alternative to surgical clipping and the primary method of choice.AimTo assess the treatment results of ruptured and unruptured ACoA aneurysms and to assess the incidence of intraprocedural complications and various factors influencing these aspects.Material and methodsOne hundred and eleven embolizations of ACoA aneurysms (80.7% ruptured and 19.3% unruptured) were retrospectively analysed. The methods of embolization were: coiling, balloon-assisted coiling, stent-assisted coiling. Morphology and dimensions of aneurysms were assessed on 3D digital subtraction angiography (DSA) images. Medical records were analysed for patient’s clinical status at admission, intraprocedural complications, follow-up examination and modified Rankin Scale (mRS) score 1 month after discharge.ResultsImmediately after the procedure 56.9% of patients had Raymond-Roy Occlusion Classification (RROC) class I, 37.6% class II and 5.5% class III. The overall intraprocedural complication rate was 6.6%. There were significantly more cases of bleeding (p = 0.012) and coil prolapse (p = 0.012) during the procedures ending with higher packing density. Twenty-eight (25.7%) patients died during hospital stay, 27 (96.4%) with ruptured aneurysm. In the follow-up of 41 patients, RROC was the same or improved in 73.2% of cases and recanalization occurred in 26.8%. Six patients with aneurysm recanalization underwent repeat embolization.ConclusionsEndovascular embolization of ACoA aneurysms is an effective and safe treatment method. The most powerful factor influencing the incidence of complications is packing density. Superior orientation of the dome, initial incomplete embolization and poor outcome in mRS scale are factors predisposing to ACoA aneurysm recurrence.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 41%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Angiographic and clinical results of anterior communicating artery aneurysm endovascular treatment.

Brzegowy¹,

Kucybała²,

Krupa³

et al. 2019

Videosurgery and Other Miniinvasive Techniques

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“…7 The risk associated with treatment of intracranial aneurysms in general is less than 0.5% mortality and less than 5% morbidity but rises to 22% mortality and 32% morbidity in high-risk groups. 8,[11][12][13] This risk is to be weighed against the risk associated with the potential rupture of the aneurysm. Often, the difference regarding risks associated with different options are small.…”

mentioning

confidence: 99%

Plea for an international Aneurysm Data Bank: description and perspectives

Bijlenga

Morel

Hirsch

et al. 2019

Neurosurgical Focus

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The disease resulting in the formation, growth, and rupture of intracranial aneurysms is complex. Research is accumulating evidence that the disease is driven by many different factors, some constant and others variable over time. Combinations of factors may induce specific biophysical reactions at different stages of the disease. A better understanding of the biophysical mechanisms responsible for the disease initiation and progression is essential to predict the natural history of the disease. More accurate predictions are mandatory to adequately balance risks between observation and intervention at the individual level as expected in the age of personalized medicine. Multidisciplinary exploration of the disease also opens an avenue to the discovery of possible preventive actions or medical treatments. Modern information technologies and data processing methods offer tools to address such complex challenges requiring 1) the collection of a high volume of information provided globally, 2) integration and harmonization of the information, and 3) management of data sharing with a broad spectrum of stakeholders.Over the last decade an infrastructure has been set up and is now made available to the academic community to support and promote exploration of intracranial disease, modeling, and clinical management simulation and monitoring.The background and purpose of the infrastructure is reviewed. The infrastructure data flow architecture is presented. The basic concepts of disease modeling that oriented the design of the core information model are explained. Disease phases, milestones, cases stratification group in each phase, key relevant factors, and outcomes are defined. Data processing and disease model visualization tools are presented. Most relevant contributions to the literature resulting from the exploitation of the infrastructure are reviewed, and future perspectives are discussed.

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Intra-procedural complications, success rate, and need for retreatment of endovascular treatments in anterior communicating artery aneurysms: a systematic review and meta-analysis

et al. 2022

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Stand-alone coil embolization of anterior communicating artery aneurysms: Efficacy and technical issues

Cited by 6 publications

References 22 publications

Angiographic and clinical results of anterior communicating artery aneurysm endovascular treatment.

Angiographic and clinical results of anterior communicating artery aneurysm endovascular treatment.

Plea for an international Aneurysm Data Bank: description and perspectives

Intra-procedural complications, success rate, and need for retreatment of endovascular treatments in anterior communicating artery aneurysms: a systematic review and meta-analysis

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