Treatment of Giant Intracranial Aneurysms

Lv, Xianli; Jiang, Chuhan; Li, Y.; Yang, Xinjian; Zhang, J.; Wu, Zhongxue

doi:10.1177/159101990901500201

Cited by 29 publications

(26 citation statements)

References 24 publications

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“…Malisch et al 20 found a 33% recanalization rate in giant aneurysms that were part of their study in 1997. The overall rate of aneurysm recanalization after coil embolization may be significantly higher in giant and very large aneurysms compared with smaller lesions [21][22][23] . Regrowth of the aneurysm, coil compaction, and coil migration into soft intra-aneurysmal thrombus are possible explanations for the faster recanalization 20 .…”

Section: Angiographic Follow-upmentioning

confidence: 96%

Clinical and Angiographic Outcome of Endovascular and Conservative Treatment for Giant Cavernous Carotid Artery Aneurysms

Zhang

et al. 2014

Interv Neuroradiol

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This study evaluated the outcome of endovascular and conservative treatment for giant cavernous carotid artery aneurysms (CCAAs). We retrospectively reviewed a series of 35 consecutive giant CCAAs treated with endovascular and conservative treatment. All patients were evaluated by balloon occlusion test (BOT) before treatment. Patients who could tolerate BOT were treated by parent artery occlusion (PAO), those who could not tolerate BOT were treated by stent/coil or conservative methods. Eight patients were treated conservatively, symptoms were worsened in four patients (50%), unchanged in three, and improved in one at 33.6±19.9 months (6∼65 months) follow-up. In 27 aneurysms treated with endovascular methods, 17 aneurysms were treated by PAO, eight aneurysms were treated with stent-assisted coil embolization, and two aneurysms were embolized with coils. The initial post-procedure angiogram revealed complete occlusion, neck remnant, and incomplete occlusion in 81.5%, 11.1%, and 7.4%, respectively. Procedure-related mortality and morbidity were 0 and 7.4%, respectively. At 33.1±17.4 months (4∼71 months) follow-up, a good clinical outcome (mRS 0–1) was observed in 25 (92.6%) patients, symptoms were resolved or improved in 20 (74.1%). Statistical analysis showed that risk factors for poor clinical outcome included age of 60 years and older (P=0.006), and conservative treatments (P=0.038). Risk factors for poor clinical outcome of giant CCAAs included conservative treatment and age older than 60 years. A symptomatic giant cavernous carotid aneurysm should be treated. The outcome of endovascular treatment of giant CCAAs is promising.

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Section: Angiographic Follow-upmentioning

confidence: 96%

Clinical and Angiographic Outcome of Endovascular and Conservative Treatment for Giant Cavernous Carotid Artery Aneurysms

Zhang

et al. 2014

Interv Neuroradiol

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“…VBA dissecting aneurysms are rare and challenging diseases with a high associated morbidity and mortality. The pathogeneses of VBA dissecting aneurysms seems to be fibro-muscular dysplasia in patients less than 40 years in age and hypertension in patients more than 40 years in age (15,16). There is a hypertension history in patients more than 40 years in age and no head trauma history in all patients.…”

Section: Discussionmentioning

confidence: 99%

“…The size of the Pcomas proved to be a good predictor of the ability to tolerate BA occlusion. Basilar artery or bilateral VA occlusion might be considered appropriate treatment in the event of recurrent or progressive enlargement of the BA aneurysm, provided that the patient's Pcomas would provide demonstrably ample collateral flow (16,29). Balloon test occlusion may be of benefit to determine if the collateral circulation is limited anatomically or compromised by vasospasm (11).…”

Section: Discussionmentioning

confidence: 99%

Endovascular management of vertebrobasilar artery dissecting aneurysms

Lv¹,

Wu²

2012

Turkish Neurosurgery

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AIm:The prognosis of VBA aneurysms seems poor and surgical management of VBA dissecting aneurysms is challenging. We evaluated our endovascular experience in management of ruptured and unruptured VBA dissecting aneurysms. mAterIAl and methOds: Eleven consecutive patients with eleven VBA aneurysms (3 ruptured and 8 unruptured) between 2008 and 2010 were retrospectively reviewed.results: Immediate postprocedural angiograms showed complete occlusion in 5 and subtotal occlusion in 2 aneurysms treated with stentassisted coiling, whereas no occlusion in 4 aneurysms treated with stenting alone. A clinical improvement or stable outcome was achieved in all patients. There was no complication in our patients and no patient died after treatment. Angiographic follow-up (mean 9.7 months, 1 to 23 months) showed complete cure in 8 aneurysms, subtotal occlusion in 2 and no occlusion in 1.COnClusIOn: VBA dissecting aneurysms can be managed by endovascular stent placement with or without coiling. In cases that cannot be treated with neurostents, proximal occlusion could be an option. BulGulAr: İşlemden hemen sonraki anjiyogramlar stent yardımlı sarmal konması ile tedavi edilmiş olan 5 anevrizmada tam oklüzyon ve 2 anevrizmada subtotal oklüzyon ve sadece stent konarak tedavi edilmiş 4 anevrizmada oklüzyon bulunmadığını gösterdi. Tüm hastalarda klinik bir düzelme veya stabil sonuç elde edildi. Hastalarımızda bir komplikasyon olmadı ve hiçbir hasta tedaviden sonra ölmedi. Anjiyografik takip (ortalama 9,7 ay, 1-23 ay) 8 anevrizmada tam kür, 2 anevrizmada subtotal oklüzyon ve 1 anevrizmada oklüzyon bulunmamasını gösterdi. sOnuÇ: VBA disekan anevrizmaları sarmal konarak veya konmadan endovasküler stent yerleştirmeyle tedavi edilebilir. Nörostentlerle tedavi edilemeyen vakalarda proksimal oklüzyon bir seçenek olabilir.

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“…For patient consulting it will be clear to ask different reference centers in Europe what to do after finding an intracranial vascular malformation not in an acute stage (other opinions, expertise, complication rate, risk factors etc.). The interdisciplinarity and a particular knowledge of the devices and material is mandatory for the career of neurointerventionalists 16,19,20 .…”

Section: Economymentioning

confidence: 99%

Intracranial Aneurysms and Vascular Malformations: Diagnosis for Therapy

Grobovschek

Himmer²,

Wolfsgruber³

et al. 2011

Neuroradiol J

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In the second part of our overviewstudy the diagnosis for the treatment of our patients with intracranial vascular malformations (aneurysms / AVMF - arteriovenous malformations) is again shown in a region of about 500.000 inhabitants and just an overview of the outcome. This second part will be an overall comparison between the former diagnostic for the treatment and the here described diagnostic for the treatment (CTA, MRA, DSA rot / microsurgery, endovascular interventional techniques etc.), concerning also the topography and the demography. The future trends are also outlined.

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Treatment of Giant Intracranial Aneurysms

Cited by 29 publications

References 24 publications

Clinical and Angiographic Outcome of Endovascular and Conservative Treatment for Giant Cavernous Carotid Artery Aneurysms

Clinical and Angiographic Outcome of Endovascular and Conservative Treatment for Giant Cavernous Carotid Artery Aneurysms

Endovascular management of vertebrobasilar artery dissecting aneurysms

Intracranial Aneurysms and Vascular Malformations: Diagnosis for Therapy

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