Treatment of Intracranial Aneurysms by Embolization with Coils

Brilstra, Eva H.; Rinkel, Gabriël J.E.; Graaf, Yolanda van der; Rooij, W. J. J. van; Algra, Ale

doi:10.1161/01.str.30.2.470

Cited by 421 publications

(265 citation statements)

References 39 publications

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“…2) Furthermore, the rates of aneurysm perforation and thromboembolic events are 2.3% to 4.5% and 8.5% to 12.7%, respectively. 2,3,6,17) Complications related to the endovascular technique occurred in 13 (25.5%) of 51 patients with MCA aneurysms, comprising 3 ruptures and 10 thromboembolisms. 21) Only one intraprocedural rupture and one thromboembolic stroke occurred during the procedure in 30 patients with endovascularly treated MCA aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…2,13,22) Therefore, not only clinical follow-up but also radiological follow-up examinations are mandatory for patients who undergo coil embolization of cerebral aneurysms. Although major recurrence, which ideally requires re-treatment, occurred in 17.1% in the present study, we have never experienced patients who suffered aneurysmal bleeding during the clinical follow-up period.…”

Section: Discussionmentioning

confidence: 99%

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Endovascular Treatment With Bare Platinum Coils for Middle Cerebral Artery Aneurysms

Oishi

Yoshida

Shimizu

et al. 2009

Neurol. Med. Chir.(Tokyo)

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Middle cerebral artery (MCA) aneurysms often have unfavorable anatomical characteristics preventing successful endovascular occlusion. We reviewed the outcomes of our series of endosaccular embolization of MCA aneurysms using bare platinum coils, angiographic images, and medical records. Immediate and follow-up angiographic results were categorized as complete occlusion, residual neck, and residual flow. Follow-up angiographic changes were categorized as unchanged, minor or major recurrence, and progressive thrombosis. Between December 2001 and August 2007, 112 patients with 113 MCA aneurysms underwent endovascular treatment, of whom 60 presented with subarachnoid hemorrhage (SAH) due to MCA aneurysm rupture. Immediate angiographic outcomes for 103 aneurysms revealed complete occlusion in 64, residual neck in 21, residual flow in 18, and failed embolization in 10. Follow-up angiography of 70 aneurysms demonstrated 41 unchanged, 10 minor recurrences, 12 major recurrences, 7 progressive thromboses, and no bleeding of coil embolized aneurysms. Outcomes of 58 SAH patients treated endovascularly revealed 45 good recovery and moderate disability, 10 severe disability or persistent vegetative state, and 3 deaths. Forty-four of the 45 patients with unruptured aneurysms treated endovascularly had no changes in their neurological status. One of 5 patients with complications had permanent morbidity. For patients with MCA aneurysms suitable for endovascular surgery, bare platinum coil embolization can be performed with acceptable low morbidity and mortality rates, with a lower risk of postprocedural aneurysmal bleeding.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment With Bare Platinum Coils for Middle Cerebral Artery Aneurysms

Oishi

Yoshida

Shimizu

et al. 2009

Neurol. Med. Chir.(Tokyo)

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“…[1][2][3][4][5] Initially, aneurysms that were surgically difficult to access, such as those situated in the posterior fossa, were treated by interventional neuroradiology (INR). 6 As well, patients with high-risk medical conditions may benefit from INR as they need not be subjected to the more invasive technique of surgery.…”

Section: Méthode : C'est Une Revue De Dossiers Rétrospective De 100 Pmentioning

confidence: 99%

Anesthesia for cerebral aneurysms: a comparison between interventional neuroradiology and surgery

Lai

Manninen

2001

Can J Anesth/J Can Anesth

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Purpose: To review the anesthetic management of patients with cerebral aneurysms during treatment in the interventional neuroradiology (INR) suite compared with in the operating room.Methods: This was a retrospective chart review of 100 consecutive patients treated by endovascular coiling compared with 100 patients treated by surgical clipping of a cerebral aneurysm. Information compared and analyzed included demographics, preprocedure medical history, neurological status including location and size of aneurysm, anesthetic management, complications and patient outcome. P < 0.05 was considered significant.Results: Patients in the INR group were older (54 ± 15 vs 49 ± 12 yr), had a greater incidence of pre-procedure cardiorespiratory problems (55 vs 34 patients) and had more aneurysms located in the posterior fossa (68 vs 11) (P < 0.05). General anesthesia was used in all except seven INR patients who received conscious sedation. There were some differences in the anesthetic agents and techniques. There was less monitoring of INR patients; temperature (33 vs 99 patients), intraarterial catheter (22 vs 100), central venous catheter (4 vs 78), and evoked potential monitoring (0 vs 100). There were no differences in the incidence of documented complications or in patient outcome.Conclusion: There were some differences in the anesthetic management of patients undergoing endovascular treatment of a cerebral aneurysm compared with treatment in the operating room. The patients in the INR suite were sicker and somewhat older and they received less invasive monitoring, but the complication rate and outcome did not differ.

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“…Estudos reportam índices de morbidade de 4 a 10% e de mortalidade de 0,5-1%, menores que o do tratamento cirúrgico [10][11][12] . O que se questiona na literatura sobre a abordagem endovascular é o pequeno seguimento dos pacientes tratados.…”

Section: Resultsunclassified

Tratamento cirúrgico dos aneurismas não rotos da artéria cerebral média

Faleiro

Pimenta

Faleiro

et al. 2004

Arq. Neuro-Psiquiatr.

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Descrevemos nossa experiência no tratamento microcirúrgico de 34 pacientes portadores de aneurismas não rotos da artéria cerebral média. Houve prevalência no sexo masculino. Oitenta e três por cento dos aneurismas apresentava tamanho menor que 10 mm. Não houve óbito na presente série, com morbidade de 3% após 1 ano. Indicamos, portanto, microcirurgia como tratamento de escolha para os aneurismas não rotos da artéria cerebral média.

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Treatment of Intracranial Aneurysms by Embolization with Coils

Cited by 421 publications

References 39 publications

Endovascular Treatment With Bare Platinum Coils for Middle Cerebral Artery Aneurysms

Endovascular Treatment With Bare Platinum Coils for Middle Cerebral Artery Aneurysms

Anesthesia for cerebral aneurysms: a comparison between interventional neuroradiology and surgery

Tratamento cirúrgico dos aneurismas não rotos da artéria cerebral média

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