Endovascular Coil Embolization of 435 Small Asymptomatic Unruptured Intracranial Aneurysms: Procedural Morbidity and Patient Outcome
| Autor: | Moon Hee Han, Se Hoon Kim, Chang Wan Oh, Bae Ju Kwon, O-Ki Kwon, So-Hyang Im, Jeongeun Kim |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Aneurysm Ruptured Risk Assessment Asymptomatic Young Adult Aneurysm Risk Factors medicine.artery Occlusion Prevalence Humans Medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Child Survival rate Survival analysis Aged Aged 80 and over Korea Interventional business.industry Intracranial Aneurysm Retrospective cohort study Balloon Occlusion Middle Aged medicine.disease Survival Analysis Cerebral Angiography Surgery Survival Rate Clinical trial Treatment Outcome cardiovascular system Female Neurology (clinical) Radiology medicine.symptom Internal carotid artery business |
| Zdroj: | AJNR Am J Neuroradiol |
| ISSN: | 1936-959X 0195-6108 |
| Popis: | BACKGROUND AND PURPOSE: Whether treatment of small asymptomatic aneurysms is appropriate or not remains controversial. We performed a retrospective study on the procedural morbidity and mortality of coil embolization of small asymptomatic unruptured intracranial aneurysms (UIAs) to obtain a more generalized estimate of procedural risk. MATERIALS AND METHODS: A total of 435 small (maximum diameter ≤7 mm) asymptomatic UIAs in 370 patients were treated by coil embolization. Aneurysm sizes were determined by using 3D angiograms. We assessed procedure-related morbidity and mortality, immediate postprocedural angiographic results, short-term imaging follow-up results, and clinical outcomes. RESULTS: Initial aneurysm occlusion was complete in 334 aneurysms, near complete in 78, and incomplete in 22. One internal carotid artery (ICA) aneurysm that ruptured during the procedure was treated with parent artery occlusion. Two hundred wide-neck aneurysms were coiled with the aid of various neck-remodeling techniques. The 44 procedure-related complications were the following: 24 thromboembolisms, 11 coil protrusions or prolapses into the parent vessel, 4 intraprocedural ruptures, 3 device-related complications, and 2 femoral-access complications. We had a total of 44 (10.1%) procedure-related complications with only 1 leading to persistent neurologic deficit. Procedure-related permanent morbidity and mortality were 0.27% (1/370) and 0%, respectively. CONCLUSIONS: In this series of small unruptured asymptomatic aneurysms, endovascular treatment was achieved with good short-term angiographic outcome and low permanent neurologic impairment. The goal of this study was not to provide a conclusion about treatment guidelines for small UIA but rather to help guide future recommendations by presenting a more generalized estimate of endovascular treatment risk than is currently available. |
| Databáze: | OpenAIRE |
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