ABSTRACT
Objective:To evaluate the safety and effectiveness of one-stage intravascular interventional treatment for intracranial multiple aneurysms.Methods:From January 1, 2010 to January 1, 2018, the data of patients with multiple intracranial aneurysm undergoing one-stage endovascular embolization in the Department of Nerurosurgery, Puning People's Hospital, Guangdong Province were analyzed retrospectively. The clinical and angiographic findings at discharge and follow-up were evaluated.Results:A total of 16 patients with multiple intracranial aneurysms received one-stage endovascular treatment were enrolled. Among them, 10 were females and 6 were males; their age was 49.5±17.2 years; 5 patients were subarachnoid hemorrhage caused by rupture of intracranial aneurysms, three of them were classified as grade Ⅰ and two were classified as grade Ⅱ by the World Federation of Neurosurgical Societies (WFNS). There are a total of 35 aneurysms, 13 patients had 2 intracranial aneurysms, and 3 had 3 intracranial aneurysms. There were 3 posterior circulation aneurysms and 32 anterior circulation aneurysms; the mean diameter of the aneurysms was 6.9±3.3 mm. Fifteen aneurysms were only treated with coil embolization, and 20 aneurysms were treated with stent-assisted coil embolization. No treatment-related complications occurred. Thirteen patients were followed up for a total of 17.7±6.4 months (range, 6-28 months). The modified Rankin Scale score of 12 patients was 0 and 1 was 6 (died of rebleeding). The imaging follow-up data of 23 aneurysms in 10 patients were obtained. They were followed up for 10.2±3.3 months (range, 6-15 months), 20 aneurysms did not recur and 3 (3/23, 13.0%) recurred.Conclusions:One-stage endovascular embolization is a safe and effective treatment for multiple intracranial aneurysms, and its long-term outcome should be further evaluated.
ABSTRACT
Objective To investigate the classification of cerebral arteriovenous malformation (AVM) associated with hemodynamics correlative aneurysms and its efficiency treated by endovascular treatment.Methods The clinical data of 17 patients of AVM associated with hemodynamics correlative aneurysms undergoing endovascular treatment were analyzed retrospectively.Results Eleven cases of aneurysms with great divergence between the aneurysm and arteriovenous malformation were embolized,6 cases of aneurysms without a great divergence between the aneurysm and arteriovenous malformation,1 case of aneurysm was treated with stent,other 5 cases of aneurysms were not treated.Eleven cases of arteriovenous malformations were embolized completely,4 cases were embolized 71％-90％ and 2 cases were embolized 50％-70％.Six cases with residual were given radiotherapy.Follow-up 3 months to 3 years,there were no cases of cerebral hemorrhage or death.Unhandled 5 cases of aneurysm and 1 case of stent implantation with the follow-up by using digital subtraction angiography,laneurysm with a stent was closed.Three aneurysms were disappeared and 2 aneurysms were reduced significantly among the 5 cases of aneurysms without treatment.One case of aneurysm occlusion in patients with stent implantation.Conclusions Classification based on a great divergence artery or not between the aneurysm and arteriovenous malformation is more instructive for clinical treatmen of cerebral arteriovenous malformation associated with hemodynamics correlative aneurysm.If it has not a great divergence artery between aneurysm and arteriovenous malformation,arteriovenous malformation after a thorough treatment,aneurysms need not be treated.The endovascular treatment for cerebral arteriovenous malformation associated with hemodynamics correlative aneurysms has a good efficiency and can be treated as a priority.