Document Detail


Endovascular treatment of basilar artery trunk aneurysms with Guglielmi detachable coils: clinical experience with 41 aneurysms in 39 patients.
MedLine Citation:
PMID:  11596957     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: The authors present a retrospective analysis of their clinical experience in the endovascular treatment of basilar artery (BA) trunk aneurysms with Guglielmi detachable coils (GDCs). METHODS: Between April 1990 and June 1999,41 BA trunk aneurysms were treated in 39 patients by inserting GDCs. Twenty-seven patients presented with subarachnoid hemorrhage, six had intracranial mass effect, and in six patients the aneurysms were found incidentally. Eighteen lesions were BA trunk aneurysms, 13 were BA-superior cerebellar artery aneurysms, four were BA-anterior inferior cerebellar artery aneurysms, and six were vertebrobasilar junction aneurysms. Thirty-five patients (89.7%) had excellent or good clinical outcomes; procedural morbidity and mortality rates were 2.6% each. Thirty-six aneurysms were selectively occluded while preserving the parent artery, and in five cases the parent artery was occluded along with the aneurysm. Immediate angiographic studies revealed complete or nearly complete occlusion in 35 aneurysms (85.4%). Follow-up angiograms were obtained in 29 patients with 31 aneurysms: the mean follow-up period was 17 months. No recanalization was observed in the eight completely occluded aneurysms. In 19 lesions with small neck remnants, seven (36.8%) had further thrombosis, three (15.8%) remained anatomically unchanged, and nine (47.3%) had recanalization caused by coil compaction. In one patient (2.6%) the aneurysm rebled 8 years after the initial embolization. CONCLUSIONS: In this clinical series the authors show that the GDC placement procedure is valuable in the therapeutic management of BA trunk aneurysms. The endovascular catheterization of these lesions tends to be relatively simple, in contrast with more complex neurosurgical approaches. Endosaccular obliteration of these aneurysms also decreases the possibility of unwanted occlusion of perforating arteries to the brainstem.
Authors:
K Uda; Y Murayama; Y P Gobin; G R Duckwiler; F Viñuela
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery     Volume:  95     ISSN:  0022-3085     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-12     Completed Date:  2001-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  624-32     Citation Subset:  AIM; IM    
Affiliation:
Division of Interventional Neuroradiology, University of California at Los Angeles School of Medicine, 90024, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Ruptured / therapy
Basilar Artery* / radiography
Cerebral Angiography
Embolization, Therapeutic* / adverse effects,  instrumentation,  mortality
Equipment Design
Fatal Outcome
Female
Humans
Intracranial Aneurysm / complications,  radiography,  surgery,  therapy*
Male
Middle Aged
Recurrence
Retreatment
Subarachnoid Hemorrhage / etiology,  therapy
Treatment Outcome

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


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