Document Detail


Endovascular treatment of unruptured intracranial aneurysms with Guglielmi detachable coils: short- and long-term results of a single-centre series.
MedLine Citation:
PMID:  18258836     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Purpose of the present study is to evaluate the clinical outcome of endovascular treatment of unruptured intracranial aneurysms and to address the question of long-term stability and protection against future subarachnoid hemorrhage. METHODS: Retrospective analysis of all patients treated in a 12-year period (173 patients: age 26 to 76 yr, mean 52.2+/-10.8/202 aneurysms: size 3 to 50 mm, mean 10.0+/-8.3). RESULTS: The mortality was 0.5%; the overall morbidity was 3.5%. The most frequent complications were thromboembolic events (10.9%). Of these, 3.0% of patients suffered a stroke, leading to severe disability in 1 patient (0.5%). In 1 patient, the aneurysm ruptured during treatment, resulting in relevant neurological disability. Another patient suffered a fatal aneurysm rupture hours after treatment. The occlusion rate depended on aneurysm and neck size. Follow-up angiography revealed a decrease of the occlusion rate over time. This trend was obvious in all size categories and was most pronounced in giant aneurysms. In 3 patients (1.5%) with partially thrombosed giant aneurysms of the posterior circulation, embolization could not prevent later aneurysm rupture. There were no ruptures of any other aneurysms in the follow-up period (3.7+/-3.4 yr). CONCLUSIONS: Endovascular treatment is a highly safe procedure with low intervention-related morbidity and mortality. Long-term data for nongiant aneurysms showed good protection against rupture in the observation period. In contrast, the risk of rupture for giant aneurysms of the posterior circulation was as high as expected in observational studies.
Authors:
Harald Standhardt; Hans Boecher-Schwarz; Andreas Gruber; Thomas Benesch; Engelbert Knosp; Gerhard Bavinzski
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Publication Detail:
Type:  Journal Article     Date:  2008-02-07
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  39     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-26     Completed Date:  2008-03-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  899-904     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria. harald.standhardt@meduniwien.ac.at
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Ruptured / complications,  etiology,  mortality
Cerebral Angiography
Embolization, Therapeutic* / adverse effects,  instrumentation
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / mortality,  radiography,  therapy*
Male
Middle Aged
Nervous System Diseases / etiology
Retrospective Studies
Stroke / etiology
Thromboembolism / etiology
Treatment Outcome
Comments/Corrections
Comment In:
Stroke. 2008 Mar;39(3):743-4   [PMID:  18258829 ]

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