Document Detail


Anatomical results, rebleeding and factors that affect the degree of occlusion in ruptured cerebral aneurysms after endovascular therapy.
MedLine Citation:
PMID:  25358516     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECT: To present a series of ruptured cerebral aneurysms in consecutive non-selected patients treated with endovascular therapy, analyzing the initial degree of occlusion, its anatomical evolution mid-term and the variables that could statistically affect them.
METHODS: 251 aneurysms were first treated with coiling (embolization). 203 patients were followed up with conventional angiography for 6-8 months after the initial treatment and 182 were followed up with three-dimensional time of flight MR angiography at18-24 months. Postoperative and mid-term anatomical results were evaluated anonymously and independently using the modified Montreal Scale.
RESULTS: The initial rate of complete occlusion was 70.9%, with rates of neck remnants and aneurysm remants of 18.3% and 10.7%, respectively. The recurrence rate was 13% after 6 months and 2% between 6 months and 2 years. The rate of retreatment was 11%. Statistically, the variables that were found to be related to the initial degree of occlusion were the use of a remodeling balloon technique (p=0.012), the size of the aneurysm neck (p=0.044) and the size of the aneurysm (p=0.004). The recanalization rate at mid-term depended on the size of the aneurysm. Although aneurysms with partial occlusion initially tended to evolve to a worse degree of closure than those with complete occlusion initially, the relationship was not statistically significant (p=0.110).
CONCLUSIONS: Embolized aneurysms can develop a worse degree of closure even when the initial occlusion is complete. The degree of occlusion depends directly on morphological factors and the use of balloon-assisted techniques. The recanalization rate at mid-term depends on the size of the aneurysm and probably on the density of the packing achieved with the initial treatment.
Authors:
Eduardo Murias Quintana; Alberto Gil Garcia; Pedro Vega Valdés; Hugo Cuellar; Angela Meilán Martínez; Antonio Saiz Ayala; Serafin Costilla Garcia; Dolores Escudero Augusto; Julio Cesar Gutierrez Morales; Antonio López García
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-10-30
Journal Detail:
Title:  Journal of neurointerventional surgery     Volume:  -     ISSN:  1759-8486     ISO Abbreviation:  J Neurointerv Surg     Publication Date:  2014 Oct 
Date Detail:
Created Date:  2014-10-31     Completed Date:  -     Revised Date:  2014-11-2    
Medline Journal Info:
Nlm Unique ID:  101517079     Medline TA:  J Neurointerv Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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