Document Detail

Endovascular therapy of 500 small asymptomatic unruptured intracranial aneurysms.
MedLine Citation:
PMID:  22241382     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: Although the natural course of UIAs remains unclear, the risk of aneurysmal SAH due to small (<10 mm) asymptomatic UIAs is low. Endovascular therapy for UIAs has increased because of device development and the need for less invasive treatment. We report the results, safety, and efficacy of endovascular therapy of small asymptomatic UIAs.
MATERIALS AND METHODS: A total of 457 patients with 500 small asymptomatic UIAs (maximum diameter < 10 mm) underwent endosaccular coil embolization at Juntendo University Hospital and affiliated hospitals. We retrospectively evaluated the technical feasibility, immediate and short-to-midterm follow-up anatomic results, procedure-related complications, and clinical outcomes.
RESULTS: Endosaccular coil embolization was completed in 481 aneurysms (96.2%) and attempted in 19 (3.8%). Completed aneurysms were treated with the simple (39.5%), balloon-assisted (51.4%), and double-catheter (9.1%) techniques. Immediate angiographic outcomes were CO for 309 (64.2%) aneurysms, RN for 72 (15.0%), and RA for 100 (20.8%). Procedure-related complications occurred in 38 aneurysms (7.6%): 19 ischemic, 11 hemorrhagic, and 8 others. Permanent morbidity and mortality were 0.8% and 0.2%, respectively. Anatomic outcome of 427 aneurysms followed up for >6 months with conventional catheter or MR angiographies showed recanalization in 72 (16.9%) aneurysms, necessitating retreatment in 9.9% (mean, 31.4 months). No patients had aneurysmal SAH during the clinical follow-up period (mean, 34.7 months).
CONCLUSIONS: In this series, endovascular therapy of small asymptomatic UIAs was highly feasible with low morbidity and mortality rates.
H Oishi; M Yamamoto; T Shimizu; K Yoshida; H Arai
Publication Detail:
Type:  Journal Article     Date:  2012-01-12
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  33     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-16     Completed Date:  2012-09-21     Revised Date:  2012-12-05    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  958-64     Citation Subset:  IM    
Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan.
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MeSH Terms
Aged, 80 and over
Aneurysm, Ruptured
Endovascular Procedures / mortality*
Intracranial Aneurysm / mortality*,  surgery*
Japan / epidemiology
Middle Aged
Postoperative Complications / mortality*
Risk Assessment
Risk Factors
Survival Analysis
Survival Rate
Treatment Outcome
Young Adult
Comment In:
AJNR Am J Neuroradiol. 2012 Oct;33(9):E120; author reply E121   [PMID:  22936098 ]

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