Document Detail


Partially thrombosed intracranial aneurysms presenting with mass effect: long-term clinical and imaging follow-up after endovascular treatment.
MedLine Citation:
PMID:  20299431     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Partially thrombosed aneurysms as a distinct entity form a diverse collection of complex aneurysms characterized by organized intraluminal thrombus and solid mass. Endovascular treatment options are PVO or selective coil occlusion of the remaining lumen. We present long-term clinical and angiographic results of endovascular treatment of unruptured partially thrombosed aneurysms that presented with symptoms of mass effect.
MATERIALS AND METHODS: Between 1994 and 2008, 30 partially thrombosed aneurysms were treated by selective coiling and 26 by PVO. Of 56 aneurysms, 53 (95%) were large or giant. Neurologic recovery during a mean clinical follow-up of 42.7 months was established. Evolution of aneurysm size during a mean follow-up of 26.6 months in 46 patients was assessed with MR imaging.
RESULTS: Seventeen of 56 patients (30%) fully recovered, 22 patients (39%) partially recovered, 11 patients (20%) were unchanged, and 6 patients (11%) died. Complete recovery more often occurred after PVO than after coiling (12 of 26 versus 5 of 30, P = .02). Aneurysm size reduction occurred more often after PVO (17 of 18 versus 2 of 28, P < .001). Five aneurysms continued to grow after coiling, resulting in death in 3. During follow-up, 27 additional treatments were performed in 19 patients, all treated with coiling.
CONCLUSIONS: In partially thrombosed aneurysms presenting with mass effect, the results of PVO are much better than those of selective coiling. After coiling, additional treatments are often needed, and some aneurysms keep growing. When PVO is not tolerated or not possible, surgical options should be considered before proceeding with coiling.
Authors:
S P Ferns; W J van Rooij; M Sluzewski; R van den Berg; C B L M Majoie
Publication Detail:
Type:  Journal Article     Date:  2010-03-18
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  31     ISSN:  1936-959X     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-13     Completed Date:  2010-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1197-205     Citation Subset:  IM    
Affiliation:
Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands. s.p.ferns@amc.uva.nl
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Cerebral Hemorrhage / mortality
Child
Disease Progression
Embolization, Therapeutic / adverse effects,  mortality*
Female
Follow-Up Studies
Humans
Intracranial Aneurysm / mortality*,  pathology*
Intracranial Thrombosis* / mortality,  pathology,  therapy
Magnetic Resonance Angiography
Male
Middle Aged
Severity of Illness Index
Treatment Outcome
Young Adult

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


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