Endovascular Management of Microcerebral Aneurysms with Diameter Smaller than 3 mm: Is It Feasible and Safe?

Autor: Shihan Hadeel, Aziz Waseem, Ismael Ahmed
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Vascular Remodeling
Risk Assessment
030218 nuclear medicine & medical imaging
03 medical and health sciences
Young Adult
0302 clinical medicine
Aneurysm
Risk Factors
Complete occlusion
medicine
Neurologic deterioration
Humans
cardiovascular diseases
Prospective Studies
Endovascular treatment
Stroke
Coil embolization
Aged
Retrospective Studies
business.industry
Rehabilitation
Endovascular Procedures
Angiography
Digital Subtraction
Intracranial Aneurysm
Microsurgery
Middle Aged
medicine.disease
Microaneurysm
Embolization
Therapeutic
Cerebral Angiography
Treatment Outcome
Radiological weapon
Feasibility Studies
Surgery
Female
Neurology (clinical)
Radiology
Patient Safety
Cardiology and Cardiovascular Medicine
business
030217 neurology & neurosurgery
Zdroj: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association. 27(6)
ISSN: 1532-8511
Popis: Background The neurosurgical management of microcerebral aneurysms with diameter smaller than 3 mm remains a great challenge as many complications can occur. Aim Our target was to assess the efficacy and usefulness of endovascular treatment of these lesions. Methods We did a prospective and retrospective gathering of the results of endovascular treatments for a group of 16 patients with 16 microcerebral aneurysms. Four patients were treated by direct coil embolization, and 12 patients were managed by remodeling techniques. Results Coil embolization was technically accessible in all cases. Initial complete occlusion is achieved in 12 patients. We did not face major technical complications such as aneurysmal rupture or coil migration during the endovascular management in 15 patients. Only in 1 case the second and last coil (2⁄1 mm) migrated distally and could not be retrieved. In this case clinical evidence of neurologic deterioration and weakness in left lower limb due to right anterior cerebral artery territory stroke was evidenced in the follow-up computed tomography scan. Follow-up clinical and radiological studies were available for 9 of 12 surviving patients and showed complete occlusion in 7 cases, and in 1 case aneurysm tiny recanalization was demonstrated after 1 year, which was retreated with complete occlusion, and in another case tiny aneurysm recanalization at the neck appeared after 2 years, which was left under observation. Conclusions Endovascular treatment is a beneficial and effective therapeutic alternative to microsurgery for microaneurysms. The long-term assessment of endovascular management for these lesions was not included in that study.
Databáze: OpenAIRE
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