Long-Term Clinical and Angiographic Outcomes of Wrap-Clipping Strategies for Unclippable Cerebral Aneurysms
Yonsei Medical Journal
; : 401-409, 2014.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-19548
Responsible library:
WPRO
ABSTRACT
PURPOSE:
To evaluate the efficacy and stability of the wrap-clipping methods as a reconstructive strategy in the treatment of unclippable cerebral aneurysms. MATERIALS ANDMETHODS:
Twenty four patients who had undergone wrap-clipping microsurgery were retrospectively reviewed. Type and morphology of the treated aneurysm, utilized technique for wrap-clip procedure, and clinical outcome with angiographic results at their last follow-up were evaluated.RESULTS:
Of 24 patients, eleven patients had internal carotid artery (ICA) blister-like aneurysms, three had dissecting type aneurysms, and ten had fusiform aneurysms. The follow-up period for the late clinical and angiographic results ranged from 10 to 75 months (mean 35 months). Wrap-clipping was performed in eleven, wrap-holding clipping was in ten, and combination of wrap-clip and wrap-holding clip was in three cases. At the last angiographic follow-up study, twelve aneurysms (50%) were found to have completely healed, and nine aneurysms (38%) were at least stable. However, wrap-holding clip for the elongated blister type of ICA aneurysm was found failed, leading to fatal rebleeding in one case, and two cases of combination of wrap-clip-wrap-holding clip revealed delayed branch occlusion and marked regrowing, respectively.CONCLUSION:
Wrap-clipping strategy could be an easy and safe alternative for unclippable aneurysms. The wrapped aneurysm mostly disappeared, or at least remained stationary, after a long-term period. However, surgeons should be aware of that the wrapped aneurysm might become worse. Therefore, follow-up surveillance for an extended period should be mandatory.
Full text:
Available
Database:
WPRIM (Western Pacific)
Main subject:
Carotid Artery, Internal
/
Intracranial Aneurysm
/
Retrospective Studies
/
Follow-Up Studies
/
Blister
/
Aneurysm
/
Methods
/
Microsurgery
Type of study:
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Yonsei Medical Journal
Year:
2014
Document type:
Article