Endosaccular Treatment of Very Large and Giant Intracranial Aneurysms with Parent Artery Preservation: Single Center Experience with Long Term Follow-up
Journal of Korean Neurosurgical Society
;
: 450-457, 2018.
Artículo
en Inglés
| WPRIM
| ID: wpr-788706
ABSTRACT
OBJECTIVE:
Very large (20–25 mm) and giant (≥25 mm) intracranial aneurysms have an extremely poor natural course, and treatment of these aneurysms remains a challenge for endovascular and surgical strategies. This study was undertaken to describe our experiences of endosaccular treatment of very large and giant intracranial aneurysms with parent artery preservation.METHODS:
From January 2005 to October 2016, twenty-four very large or giant aneurysms in 24 patients were treated by endosaccular coil embolization with parent artery preservation. Nine (37.5%) aneurysms were ruptured and 15 were unruptured, and of these 15, 11 were symptomatic cases and 4 were incidentally discovered. The cohort comprised 17 women and 7 men of mean age 58.5 years (range, 26–82). Mean aneurysm size was 26.0 mm (range, 20–39) and 13 of the 24 aneurysms were giant.RESULTS:
Immediate angiographic results were complete occlusion in nine (37.5%) cases, remnant neck in six (25.0%), and remnant sac in nine (37.5%). Overall procedural related morbidity and mortality rates were 12.5% and 4.2%, respectively. Angiographic follow-up was available in 16 patients (66.7%). Mean and median follow-up periods were 27.2 (range, 2–77) and 10.5 months, respectively. In 12 cases (12/16, 75%) stable occlusion was achieved, four cases (4/16, 25%) had recanalized, and two of these were retreated with additional coiling. At clinical follow-up of the nine ruptured cases, three patients (33.3%) achieved a good clinical outcome (Glasgow outcome scale [GOS] score of 4 or 5), two (22.2%) a poor outcome (GOS score of 2 or 3), and four patients (44.4%) expired (GOS 1). On the other hand, of the 15 unruptured cases, 13 patients (86.7%) achieved a good clinical outcome (GOS 4 or 5), one patient a poor outcome (GOS score of 2 or 3), and one patient expired (GOS 1).CONCLUSION:
The present study shows endosaccular treatment of very large or giant intracranial aneurysms with parent artery preservation is both feasible and effective with acceptable morbidity and mortality.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Padres
/
Arterias
/
Aneurisma Intracraneal
/
Estudios de Cohortes
/
Estudios de Seguimiento
/
Mortalidad
/
Embolización Terapéutica
/
Mano
/
Aneurisma
/
Cuello
Tipo de estudio:
Estudio de etiología
/
Estudio de incidencia
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Journal of Korean Neurosurgical Society
Año:
2018
Tipo del documento:
Artículo
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