Document Detail


Endovascular treatment of very small unruptured aneurysms: rate of procedural complications, clinical outcome, and anatomical results.
MedLine Citation:
PMID:  21030707     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: The strategy of treatment of small unruptured intracranial aneurysms is complex because of their presumably low risk of rupture. A precise knowledge of the perioperative complications in this specific subgroup is mandatory. The purpose of this study was to compare the results of the endovascular treatment of aneurysms ≤ 3 mm and aneurysms > 3 mm included in the Analysis of Treatment by Endovascular Approach of Nonruptured Aneurysms study.
METHODS: The study included 626 patients harboring 682 unruptured aneurysms. Perioperative adverse events and clinical outcome were analyzed in patients treated for aneurysms ≤ 3 mm (51 patients, 51 aneurysms) and in patients treated for aneurysms > 3 mm (575 patients, 631 aneurysms).
RESULTS: Endovascular treatment failed more often in aneurysms ≤ 3 mm (13.7%) compared to aneurysms > 3 mm (3.3%; P = 0.003). The rate of intraoperative rupture for aneurysms ≤ 3 mm (3.9%; 95% CI, 0.5-13.5) did not significantly differ compared to aneurysms > 3 mm (2.4%; 95% CI, 1.2-3.6; P = 0.37). Thromboembolic events were not significantly different in both groups (3.9%; 95% CI, 0.5-13.5 in very small aneurysms and 7.1%; 95% CI, 5.1-9.1 in larger aneurysms; P = 0.57). One month morbidity/mortality was not significantly different for patients with very small aneurysms (2.0%; 95% CI, 0.05-10.45) and for patients with larger aneurysms (3.3%; 95% CI, 1.8-4.8; P = 0.60).
CONCLUSIONS: The risks of endovascular treatment are similar in patients with very small or with larger aneurysms. Because the risk of spontaneous rupture is lower in very small aneurysms, their management will include follow-up MRI and active treatment in case of morphological modification.
Authors:
Laurent Pierot; Coralie Barbe; Laurent Spelle;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-28
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  41     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-30     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2855-9     Citation Subset:  IM    
Affiliation:
Service de Radiologie-Hôpital Maison-Blanche, 45, rue Cognacq-Jay, 51092 Reims Cedex, France. lpierot@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Ruptured / surgery
Female
Humans
Intracranial Aneurysm / mortality,  pathology*,  surgery*
Magnetic Resonance Imaging
Male
Middle Aged
Perioperative Care
Retrospective Studies
Thromboembolism / epidemiology,  etiology
Treatment Failure
Treatment Outcome
Vascular Surgical Procedures* / adverse effects

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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