scholarly journals Immediate Anatomic Results after the Endovascular Treatment of Unruptured Intracranial Aneurysms: Analysis of the ATENA Series

2009 ◽  
Vol 31 (1) ◽  
pp. 140-144 ◽  
Author(s):  
L. Pierot ◽  
L. Spelle ◽  
F. Vitry ◽  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
Anatomic Results

scholarly journals Endovascular Treatment of Unruptured Intracranial Aneurysms

2011 ◽  
Vol 17 (4) ◽  
pp. 420-424 ◽  
Author(s):  
W. Yue
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Mass Effect ◽  
Mortality And Morbidity ◽  
Unruptured Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
Mean Size ◽  
Large And Giant Aneurysms ◽  
Brain Stem Ischemia

We report the clinical and angiographic results of endovascular treatment of unruptured intracranial aneurysms. Over a three-year period, 80 unruptured aneurysms in 74 patients were electively treated with endovascular management. One aneurysm was diagnosed during investigations for a second ruptured aneurysm, 54 aneurysms were incidentally discovered, 18 aneurysms presented with symptoms of mass effect and seven aneurysms presented with symptoms of brain stem ischemia. Mean size of the 80 unruptured aneurysms was 12.5±8.0 mm (range, 2–39 mm). Thirty-six aneurysms (45%) were small (<10 mm), 38 aneurysms (47.5%) were large (10–25 mm), and six aneurysms (7.5%) were giant (25–39 mm). Forty-eight wide-necked aneurysms (60%) were coiled with the aid of a supporting device. The mortality rate was 1.25%, and the overall morbidity was 1.25%. Of these, one of the patients suffered a stroke, leading to severe disability (1.25%). In one patient, the aneurysm ruptured during treatment, resulting in death. Initial aneurysm occlusion was complete (100%) in 76.25% aneurysms, nearly complete (90%–98%) in 10% aneurysms and incomplete (60%–85%) in 13.75% aneurysms. Follow-up angiography was available in 67 patients with 73 treated aneurysms (91.25%) from one to 36 months (mean 9.3 months); partial reopening occurred in 7.5%, mainly large and giant aneurysms (5.5%). Additional coiling was performed in four aneurysms. There were no complications in additional treatments. At 14.1-month clinical follow-up (range, 2 to 36 months), mRS score was 0 in 78.75% patients, 1 in 10% patients, 2 in 8.75% and 3 in 1.25%. There was no aneurysmal rupture during the follow-up period. Endovascular treatment of unruptured intracranial aneurysms has low procedural mortality and morbidity rates.

scholarly journals Single-Center Retrospective Series of Intracranial Aneurysms Treated with the Barricade Coil System: Immediate and Six-Month Results

2020 ◽  
Vol 74 (3) ◽  
pp. 181-187
Author(s):  
Kārlis Kupčs ◽  
Aigars Lācis ◽  
Zane Saleniece ◽  
Helmuts Kidikas
Keyword(s):  
Clinical Outcome ◽  
Endovascular Treatment ◽  
Stent Implantation ◽  
Intracranial Aneurysms ◽  
Neurological Symptoms ◽  
University Hospital ◽  
Complete Occlusion ◽  
Coil System ◽  
Unruptured Intracranial Aneurysms ◽  
First Choice

AbstractIntracranial aneurysms (IAs) are most commonly found at the branch points of large arteries that form the circle of Willis. The prevalence of IAs in the adult population is 1–5%. IAs rupture is associated with subarachnoid haemorrhage (SAH) in 6–8 cases per 100 000 population, causing mortality in 40–50%. Aneurysm treatment is used to prevent rupture or rebleeding (for ruptured IAs). Randomised trials demonstrated the superiority of endovascular treatment (EVT) of ruptured aneurysms with coil systems over surgery. The objective of the study was to evaluate the effectiveness of the Barricade coil system in the treatment of intracranial aneurysms. Detachable platinum coils, since their introduction 25 years ago, have become the first choice EVT method for ruptured and unruptured IAs and have shown acceptable mortality (~2%). The retrospective study of intracranial aneurysms treated with the Barricade coil system at Pauls Stradiņš Clinical University Hospital (Rīga, Latvia) conducted in a 20-month period included 95 patients and 97 IAs. Thirty-one (32.6%) males and 64 (67.4%) females with median age 56 ± 15 years underwent endovascular treatment. The minority, 22 (23.16%) patients, were asymptomatic, while 73 (76.84%) patients had neurological symptoms directly associated with aneurysm progression and SAH development. Preoperatively, 52 (53.6%) aneurysms were ruptured, causing SAH, and 24 (25.26%) patients with unruptured IAs had neurological symptoms. Sixty-four (66.0%) IAs were treated using coils without neurovascular stent implantation or balloon assistance, 22 (22.7%) — with coils and stent implantation, and 11(11.3%) aneurysms were embolised with balloon-assisted coiling. The immediate anatomical result of endovascular treatment of IAs and technical success of aneurysm coiling was evaluated using the simplified Raymond scale. In the majority of cases, complete occlusion of the aneurysm was achieved while residual neck of the aneurysm or aneurysm remnant was uncommon. Immediate clinical results were evaluated using the modified Rankin scale (mRs). The majority of patients had favourable immediate clinical outcome (mRs 0–2), but four (4.21%) patients died in 1–6 days after the procedure as a consequence of SAH. In 72 (75.79%), patients no new neurological pathological symptoms developed 2–3 days after endovascular procedure and they were discharged from the hospital. Intraprocedural complications occurred in 4 (4.21%) cases. Technical issues occurred in two (2.1%) patients. In 19 (20%) patients, neurological symptoms remained even after the procedure, six (6.32%) patients had clinical worsening, and we had one case of procedural related mortality. Six-month follow-up evaluation was performed for 58 (61.0%) patients (59 IAs). In the majority of cases, complete occlusion of the aneurysm and favourable clinical outcome (mRs 0–2) was observed. Our experience showed that the treatment of ruptured and unruptured intracranial aneurysms with the Barricade coil system is feasible, effective, clinically safe and has a low risk of intraprocedural complications.

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