Document Detail


Endovascular coil embolization of anterior choroidal artery aneurysms. Clinical article.
MedLine Citation:
PMID:  19463045     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Anterior choroidal artery (AChA) aneurysms are difficult to treat, and the clinical outcome of patients is occasionally compromised by ischemic complications after clipping operations. The purpose of this study was to document the outcome and follow-up results of endovascular coil embolization in patients with AChA aneurysms. METHODS: Between July 1999 and March 2008, 88 patients with 90 AChA aneurysms (31 ruptured and 59 unruptured aneurysms) were treated with endovascular coil embolization in 91 sessions. There were 87 small aneurysms (< 10 mm) and 3 large aneurysms, with a mean aneurysm volume of 60.9 +/- 83.3 mm(3). Preprocedural oculomotor nerve palsy associated with AChA aneurysms was noted in 8 patients. Efficacy and safety were evaluated based on the degree of initial occlusion, procedure-related complications, patient outcome based on the Glasgow Outcome Scale score, and follow-up results. RESULTS: The degree of angiographic occlusion of the aneurysms was complete for 15 aneurysms (17%), near complete for 69 aneurysms (77%) and partial for 6 aneurysms (7%). There were 4 (4.4%) symptomatic procedure-related complications (3 thromboembolic events and 1 procedural hemorrhage). The procedural hemorrhage resulted in death; however, the thromboembolic events only caused transient deficits. A favorable outcome (Glasgow Outcome Scale score of 5 or 4) was achieved in 90% (79 of 88) of the patients at the time of discharge. No patient showed signs of bleeding or rebleeding during the follow-up period (mean 25 months). Major aneurysm recanalization occurred in 2 cases. The AChA aneurysm-associated oculomotor nerve palsy tended to become aggravated transiently after coil embolization and then completely recovered over the course of 2-9 months. CONCLUSIONS: Coil embolization is a safe and effective treatment modality in cases of AChA aneurysms. Coil embolization enables procedural recognition of arterial compromise and immediate reestablishment of flow, thus contributing to a favorable outcome.
Authors:
Hyun-Seung Kang; Bae Ju Kwon; O-Ki Kwon; Cheolkyu Jung; Jeong Eun Kim; Chang Wan Oh; Moon Hee Han
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  111     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-02     Completed Date:  2009-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  963-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Loss, Surgical
Cerebral Angiography
Cerebral Infarction / etiology,  therapy*
Embolization, Therapeutic* / adverse effects
Female
Follow-Up Studies
Glasgow Outcome Scale
Humans
Hyperplasia / pathology
Intracranial Aneurysm / complications,  therapy*
Magnetic Resonance Angiography
Male
Middle Aged
Ophthalmoplegia / etiology
Thromboembolism / etiology
Treatment Outcome

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


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