Document Detail


Endovascular treatment of 174 middle cerebral artery aneurysms: clinical outcome and radiologic results at long-term follow-up.
MedLine Citation:
PMID:  19703857     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To retrospectively evaluate the immediate safety and efficacy as well as the clinical outcome and long-term angiographic results of endovascular treatment (EVT) of middle cerebral artery (MCA) aneurysms. MATERIALS AND METHODS: This is a retrospective review of patients in whom coiling of MCA aneurysms was attempted over a 7-year period. Institutional review board approval and informed written consent were obtained. This study included 153 patients (90 women, 63 men; mean age, 49.5 years +/- 11.7 [standard deviation]) with 174 MCA aneurysms (71 unruptured, 103 ruptured). Complications of EVT, clinical outcome, and the results of either cerebral digital subtraction angiography (DSA) or magnetic resonance (MR) angiography were analyzed at initial, intermediate (6-18 months), and late (2-7 years) follow-up. RESULTS: Coiling was performed in 160 (92%) aneurysms in 141 patients. Periprocedural complications were observed in 31 (19.4%) procedures, including aneurysm perforations (n = 7, 4.4%) and thromboembolic events (n = 24, 15.0%). EVT induced permanent morbidity in eight (5.7%) patients, with severe neurologic impairment in three (2.1%) and two deaths (1.4%). Of 114 MCA aneurysms controlled by using DSA (n = 50) or MR angiography (n = 64) at 50 months +/- 14, 73 (64%) remained completely occluded, 31 (27.2%) recurred, and 12 (10.5%) major recurrences were retreated. A balloon remodeling technique allowed treatment of complex aneurysms (n = 63) but was associated with more recurrences in the long term (42.6%) than aneurysms treated without balloon assistance (16.4%; P = .016). CONCLUSION: EVT of MCA aneurysms was safe and long-term monitoring of patients showed a low rate of recurrence requiring retreatment. However, complex anatomy and long-term recurrences have to be addressed when considering EVT for MCA aneurysms.
Authors:
Jean-François Vendrell; Nicolas Menjot; Vincent Costalat; Denis Hoa; Jorge Moritz; Herve Brunel; Alain Bonafe
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Publication Detail:
Type:  Journal Article     Date:  2009-07-31
Journal Detail:
Title:  Radiology     Volume:  253     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-30     Completed Date:  2009-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  191-8     Citation Subset:  AIM; IM    
Affiliation:
Department of Neuroradiology, University Hospital Center, Gui de Chauliac Hospital, 80 Avenue Augustin Fliche, 34295 Montpellier Cedex 5, France.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography, Digital Subtraction
Cerebral Angiography / methods*
Chi-Square Distribution
Embolization, Therapeutic*
Female
Humans
Intracranial Aneurysm / diagnosis,  therapy*
Magnetic Resonance Angiography
Male
Middle Cerebral Artery*
Recurrence
Retrospective Studies
Statistics, Nonparametric
Treatment Outcome

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


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