Wide-necked Intracranial Aneurysms: Treatment with Stent-assisted Coil Embolization during Acute (&lt;72 Hours) Subarachnoid Hemorrhage—Experience in 61 Consecutive Patients

Tähtinen, Olli; Vanninen, Ritva; Manninen, Hannu; Rautio, Riitta; Haapanen, Arto; Niskakangas, Tero; Rinne, Jaakko; Keski-Nisula, Leo

doi:10.1148/radiol.2531081923

Cited by 164 publications

(127 citation statements)

References 25 publications

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“…In this series, 82.2% patients were of good-grade (Hunt-Hess grade I or II) and this may associated with our favorable clinical outcomes. Contrast to 2.8% to 5.1% complication rate in other endovascular series (14,20), there was no procedure-related complication in our series.…”

Section: █ Discussioncontrasting

confidence: 90%

Clinical and angiographic outcomes of endovascular treatment for ruptured posterior circulation cerebral aneurysms

Liu

Li²,

Sun³

et al. 2012

Turkish Neurosurgery

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Section: █ Discussioncontrasting

confidence: 90%

Clinical and angiographic outcomes of endovascular treatment for ruptured posterior circulation cerebral aneurysms

Liu

Li²,

Sun³

et al. 2012

Turkish Neurosurgery

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“…Previous studies showed initial complete occlusion rates from 27-73 % [37][38][39][40] in treating aneurysms by stentassisted coiling; compared with these studies, our results appeared moderate (63 % in group A and 44 % in group B). The cases included in the present series were all widenecked and ruptured aneurysms, thus posing a challenge to angiographic occlusion.…”

Section: Discussioncontrasting

confidence: 65%

Stent-Assisted Coil Embolization for the Treatment of Ruptured Aneurysms at the Anterior Circulation: Comparison Between HydroSoft Coils and Bare Platinum Coils

Che

Hong

et al. 2013

Cardiovasc Intervent Radiol

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Purpose To evaluate the perioperative safety and midterm prognosis (B12 months) of HydroSoft coils in treating ruptured aneurysms at the anterior circulation compared with bare platinum coils. Materials and Methods Patients with aneurysmal subarachnoid hemorrhages admitted to our hospital between January 2009 and March 2012 were retrospectively analyzed. According to strict inclusion and exclusion criteria, cases were selected and classified into two groups: In group A, HydroSoft coils were used as the primary filling coils (C40 % of total coil length); in group B, only bare platinum coils were used. Cases in both groups were all treated with stent-assistance. A comparison between the two groups was performed for periprocedural complications as well as immediate and mid-term outcomes. The stents used included Enterprise, Neuroform, and Solitaire.Results Fifty-six aneurysms were in group A patients, and 68 aneurysms were in group B patients. Compared with group B, group A did not have increased incidence of complications but had greater packing attenuation (44.5 ± 8.8-29.8 ± 9.1 %, t = 2.577, P = 0.014) and increased initial complete occlusion rates (63-44 %, v 2 = 4.161, P = 0.041). Radiologic follow-up were performed in 46 patients from group A and 51 patients from group B. Complete occlusion rates at follow-up were significantly greater in group A than in group B (89.1-70.6 %, v 2 = 5.08, P = 0.043); the difference in recanalization rates were statistically insignificant between the groups (6.5-5.9 %, P = 1.000). Conclusion HydroSoft coils proved safe during the periprocedural period and provided greater initial complete occlusion rates, greater packing density, and better followup results compared with bare platinum coils.

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“…58,60 In this setting, plagued by the specter of early rerupture, the cerebrovascular neurosurgeon must safely expose these complex aneurysms and adjacent vital perforators while navigating an edematous, "angry" brain.…”

Section: Neurosurg Focus 33 (2):e9 2012mentioning

confidence: 99%

“…Despite the preponderance of endovascular approaches to these lesions, 15,36,45,53,58 some may remain refractory to safe endovascular management. In several cases we reviewed endovascular treatment had previously been attempted without success.…”

Section: Looking Forwardmentioning

confidence: 99%

“…9,34 Employed as a necessary means to curb thromboembolic complications, requisite dual antiplatelet therapy relatively contraindicates usage of endovascular stent placement in instances of acute subarachnoid hemorrhage. 58,60 In this setting, plagued by the specter of early rerupture, the cerebrovascular neurosurgeon must safely expose these complex aneurysms and adjacent vital perforators while navigating an edematous, "angry" brain.…”

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confidence: 99%

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Petrosal approaches to posterior circulation aneurysms

Gross

Tavanaiepour²,

Du³

et al. 2012

FOC

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Complex posterior circulation aneurysms are formidable lesions with an abysmal natural history. Their management continues to present a challenge to both endovascular and open microsurgical approaches. Affording an expansive, combined supra- and infratentorial exposure, the petrosal approaches are well suited for these challenging lesions when located along the basilar trunk or at a low-lying basilar apex. This report evaluates the evolution and application of petrosal approaches to these lesions. Excluding transsigmoid, infratentorial, or labyrinth-sacrificing approaches, the authors found 23 reports with 61 posterior circulation aneurysms treated via a petrosal approach. Although early morbidity was not negligible, rates of aneurysm occlusion (95% overall) and long-term outcome were quite laudable in light of the challenge posed by these lesions. Moreover, with accumulating experience with petrosal approaches, rates of complications are likely to wane, as neurosurgeons capitalize on the expansive exposure afforded by these indispensable approaches.

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Wide-necked Intracranial Aneurysms: Treatment with Stent-assisted Coil Embolization during Acute (<72 Hours) Subarachnoid Hemorrhage—Experience in 61 Consecutive Patients

Cited by 164 publications

References 25 publications

Clinical and angiographic outcomes of endovascular treatment for ruptured posterior circulation cerebral aneurysms

Clinical and angiographic outcomes of endovascular treatment for ruptured posterior circulation cerebral aneurysms

Stent-Assisted Coil Embolization for the Treatment of Ruptured Aneurysms at the Anterior Circulation: Comparison Between HydroSoft Coils and Bare Platinum Coils

Petrosal approaches to posterior circulation aneurysms

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