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Factors Leading to and Treatment of Aneurysmal Perforation during Coil Embolization. Analysis of 105 Consecutive Cases.
MedLine Citation:
PMID:  20591299     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
It is important to know the characteristics of aneurysms that tend to cause perforation and treatment of these perforations to reduce the morbi/mortality of the endovascular treatment for intracranial aneurysms. Factors leading to aneurysmal perforation were analyzed from the view points of aneurysmal status (ruptured or unruptured), size and direction of aneurysmal dome from the parent artery and treatment of perforation during GDC embolization was discussed in 105 consecutive cases. Perforation occurred in three small aneurysms (less than 3 mm in diameter or depth) where the direction of the dome is the same as that of microcatheter advancement. Perforation occurred when a microcatheter was advanced to counteract catheter recoil caused by coil deployment. Haemorrhage occurred in all cases immediately following microcatheter and coil perforation into the subarachnoid space. In all cases, bleeding was controlled by deploying the coil so that it extended from the subarachnoid space back into the intraaneurysmal cavity. In two cases, surgical clipping was required to treat the incompletely obliterated aneurysm. No additional permanent neurological deficit occurred as a result of any of the three perforations. Special care should be taken during the embolization of small aneurysms (less than 3 mm in minimal diameter) where, owing to the shape of the lesion, or fixation of a microcatheter by the stent strut, the antegrade force of the canulating microcatheter is transmitted directly toward the aneurysm dome.
Authors:
T Terada; M Tsuura; H Matsumoto; O Masuo; A Shintani; Y Ryujin; T Itakura
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Publication Detail:
Type:  Journal Article     Date:  2004-10-22
Journal Detail:
Title:  Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences     Volume:  9     ISSN:  1591-0199     ISO Abbreviation:  Interv Neuroradiol     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2010-07-01     Completed Date:  2012-10-02     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  9602695     Medline TA:  Interv Neuroradiol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  21-9     Citation Subset:  -    
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