Document Detail

The fate of intracranial microaneurysms treated with bipolar electrocoagulation and parent vessel reinforcement.
MedLine Citation:
PMID:  10549934     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Although direct clipping remains the treatment of choice for intracranial aneurysms, not all aneurysms can be clipped. This report reviews the results of bipolar coagulation followed by parent vessel reinforcement for the treatment of intracranial microaneurysms (maximal diameter of < or =3 mm), with immediate and delayed postoperative angiographic evaluation in all cases. METHODS: During a 1-year period, 20 intracranial microaneurysms in 12 patients were treated with bipolar electrocoagulation followed by reinforcement of the parent artery with muslin gauze. All patients underwent intraoperative or immediate postoperative angiographic evaluation, and all underwent follow-up angiographic evaluation approximately 1 year later. No patient was lost to follow-up monitoring. RESULTS: Microaneurysms involved the middle cerebral artery (eight cases), internal carotid artery (six cases), anterior cerebral/anterior communicating artery (five cases), and superior cerebellar artery (one case). In all cases, the patient was undergoing a craniotomy for clipping of a larger aneurysm, and the microaneurysms were treated concurrently. At the time of the immediate angiographic examinations, 19 of 20 (95%) microaneurysms were no longer visible and 1 was substantially smaller (< 1-mm irregularity on the parent vessel). No patient experienced an adverse event related to microaneurysm treatment. In the 1-year follow-up examinations, there was no angiographic evidence of recurrence in the 19 cases with complete obliteration; the one residual aneurysm remained stable. CONCLUSION: At 1 year, direct coagulation followed by parent vessel reinforcement seems to provide a satisfactory treatment option for intracranial microaneurysms.
E S Nussbaum; D L Erickson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  45     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  1999 Nov 
Date Detail:
Created Date:  1999-12-16     Completed Date:  1999-12-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1172-4; discussion 1174-5     Citation Subset:  IM    
Department of Neurological Surgery, University of Minnesota Hospital and Clinic, Minneapolis 55455, USA.
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MeSH Terms
Cerebral Angiography*
Intracranial Aneurysm / radiography,  surgery*
Postoperative Complications / radiography
Surgical Instruments
Surgical Mesh*
Treatment Outcome

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