Document Detail


Transcirculation Endovascular Treatment of Complex Cerebral Aneurysms: Technical Considerations and Preliminary Results.
MedLine Citation:
PMID:  21192273     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: Unfavorable anatomy can preclude embolization of intracranial aneurysms. Transcirculation techniques, in which a catheter is navigated from one side of the brain to the other or from the anterior to the posterior circulation, are alternative pathways for primary or balloon/stent-assisted coiling. OBJECTIVE:: We report the largest experience in coil embolization of aneurysms using transcirculation techniques. METHODS:: We reviewed our endovascular database from 2006 to 2009 and identified 18 patients who had aneurysms treated with transcirculation techniques. RESULTS:: Eight patients had anterior and 10 had posterior circulation aneurysms. Overall, 8 patients were treated with stent-assisted coiling and 9 with balloon-assisted coiling, including 1 patient treated with a "kissing balloon" technique. Of the 9 patients treated with balloon-assistance, 1 was also stented at the conclusion of aneurysm coiling. One patient with a left V4 aneurysm was treated with coiling alone via a bilateral vertebral artery approach. In 14 patients, the anterior communicating and posterior communicating arteries were used as conduits. In 4 patients, both VAs were traversed to treat 2 V4 aneurysms and 2 posterior inferior cerebellar artery aneurysms. One patient died as a result of treatment and was the only permanent complication (5.6%). Complete or near complete (>95%) embolization was achieved in all patients. CONCLUSION:: Transcirculation techniques are effective pathways for embolization of complex aneurysms. Although technically challenging, these techniques are associated with an acceptably low rate of complications when compared to the natural history of the treated lesion.
Authors:
Felipe C Albuquerque; L Fernando Gonzalez; Yin C Hu; C Benjamin Newman; Cameron G McDougall
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2010-12-16
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
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