Document Detail


Clinical and angiographic long-term follow-up of completely coiled intracranial aneurysms using endovascular technique.
MedLine Citation:
PMID:  19361261     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The anatomical evolution and clinical outcome of completely coiled intracranial aneurysms after endovascular embolization have rarely been studied separately. From their prospective database, the authors reviewed follow-up angiography and clinical outcome of 87 patients whose aneurysms were designated as 100% obliterated on immediate postembolization angiography. METHODS: Ninety-one aneurysms (56 ruptured and 35 unruptured) in 87 patients were included in this study. Clinical outcome was evaluated using the Glasgow Outcome Scale. Follow-up angiographic findings were assessed and categorized as 1 of the following: no recanalization, recanalization with a neck remnant, or recanalization with a body remnant. For statistical analysis, the recanalization rate was correlated with: clinical presentation; the largest aneurysm diameter, aneurysm neck size, and dome-to-neck ratio; aneurysm location; and use of special techniques such as usage of a surface modified coil, balloon remodeling technique, or stent. RESULTS: At the latest clinical evaluation (mean 34.3 months), 81 (93.1%) of the 87 patients (91 aneurysms) had good clinical outcomes (Glasgow Outcome Scale Score 5). The procedure-related morbidity rate (permanent neurological deficit) was 2.3% (2 of 87), and there were no procedure-related deaths. On the latest follow-up angiography (mean 26.4 months), the recanalization rate was 26.4% (24 of 91 aneurysms): 16 (17.6%) with neck remnants and 8 (8.8%) with body remnants. The neck size of the recanalized aneurysms was statistically significantly larger than that of the nonrecanalized aneurysms (p = 0.006), and aneurysms with wide necks (> or = 4 mm) had a higher recanalization rate than those with a narrow neck (< 4 mm) (p = 0.002). There was no bleeding after endovascular treatment during the follow-up period. CONCLUSIONS: Completely coiled aneurysms after endovascular embolization demonstrated good clinical outcome, and there was no bleeding episode after endovascular treatment; however, there was a relatively high recanalization rate.
Authors:
Dae Seob Choi; Mun Chul Kim; Seon Kyu Lee; Robert A Willinsky; Karel G Terbrugge
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  112     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-02     Completed Date:  2010-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  575-81     Citation Subset:  AIM; IM    
Affiliation:
Department of Radiology, Gyeongsang National University School of Medicine, Jinju, South Korea.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aneurysm, Ruptured / pathology,  therapy
Cerebral Angiography
Databases, Factual
Embolization, Therapeutic* / adverse effects,  methods
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / pathology*,  therapy*
Male
Middle Aged
Prospective Studies
Severity of Illness Index
Time Factors
Treatment Outcome
Young Adult
Comments/Corrections
Erratum In:
J Neurosurg. 2010 Mar;112(3):690

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