Document Detail


Impact of individual intracranial arterial aneurysm morphology on initial obliteration and recurrence rates of endovascular treatments: a multivariate analysis.
MedLine Citation:
PMID:  20932093     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Object The goal was to investigate whether morphological features of aneurysms can be identified that determine initial success and recurrence rates of coiled aneurysms of the basilar artery tip, the posterior communicating artery (PCoA), and the anterior communicating artery. Methods The authors evaluated 202 aneurysms in connection with their pretreatment morphological features including size, neck-to-dome ratio, angulation of the aneurysm in relation to the parent artery, orientation of the aneurysm dome, and associated anatomical variations. The mean follow-up was 19 months (range 6-96 months) after endovascular coil occlusion. Using multivariate logistic regression, probabilities for initial complete occlusion and long-term stability of the treatment were calculated. Results Recanalization occurred in 49 of 202 cases. Favorable factors for long-term stability included small aneurysms with small necks. However, additional factors related to local hemodynamic forces could be identified for the different aneurysm locations, which may influence initial success rates and long-term stability of aneurysm treatment with endovascular coiling. These factors were a medial dome orientation and a symmetrical disposition of both A(1) segments (for the anterior communicating artery), a posteroinferior dome orientation and a small-size PCoA (for the PCoA), and a cranial symmetrical fusion (for the basilar artery tip). Conclusions A detailed pretreatment analysis of morphological features of aneurysms may help to determine those aneurysms that are more prone to recurrence, which could add to the treatment decision and the follow-up algorithm.
Authors:
Dittapong Songsaeng; Sasikhan Geibprasert; Karel G Ter Brugge; Robert Willinsky; Michael Tymianski; Timo Krings
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Publication Detail:
Type:  Journal Article     Date:  2010-10-08
Journal Detail:
Title:  Journal of neurosurgery     Volume:  114     ISSN:  1933-0693     ISO Abbreviation:  J. Neurosurg.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0253357     Medline TA:  J Neurosurg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  994-1002     Citation Subset:  AIM; IM    
Affiliation:
Division of Neuroradiology, Department of Medical Imaging, and.
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