Endovascular Coil Occlusion of 1811 Intracranial Aneurysms: Early Angiographic and Clinical Results

Henkes, Hans; Fischer, Sebastian; Weber, W.; Miloslavski, E.; Felber, Stephan; Brew, Stefan; Kuehne, D.

doi:10.1227/01.neu.0000103221.16671.f0

Cited by 274 publications

(209 citation statements)

References 47 publications

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“…The rate of thromboembolic complications and the morbidity and mortality rates were not significantly different in the conventional coil embolization and balloon remodeling groups. In previously reported series, the thromboembolic complication rate has ranged from 2.5% to 28% (18,25). In a large series consisting of 717 patients, Renowden et al (8) reported a thromboembolic complication rate of 4.4%.…”

Section: Discussionmentioning

confidence: 92%

“…Several clinical, technical, and anatomical factors are implicated in the recanalization rate observed after cerebral aneurysm coiling (16,17). The aneurysm diameter (>10 mm) and neck width (>4 mm) are the main factors determining the final degree of occlusion achieved (18). In addition to these factors, incomplete coiling or underpacking during the initial aneurysm treatment increases the rate of recanalization during the follow-up period.…”

Section: Discussionmentioning

confidence: 99%

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Thirteen-year experience with coil embolization of 481 ruptured intracranial aneurysms: angiographic and clinical results

Dinç

Öztürk²,

Sarı³

et al. 2012

Diagn Interv Radiol

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, 481 patients with ruptured aneurysms were referred for endovascular treatment with detachable coils at our center. The technical feasibility, procedural complications, morbidity, mortality, and initial angiographic and clinical results were evaluated. RESULTSEndovascular treatment was successful in 95.6% of the patients. Postembolization angiography showed complete occlusion in 63.4%, a neck remnant in 30.8%, and incomplete occlusion in 5.8% of the aneurysms. A total of 331 patients were followed up. The overall angiographic results showed stable occlusion in 234 aneurysms (70.7%) and recurrence in 97 aneurysms (29.3%). During the follow-up period, stable angiographic occlusion was evident in 75% of the small, 61% of the large, and 38.5% of the giant aneurysms. Complications during the coiling procedure occurred in 75 procedures (15.6%). Ischemic complications were observed in 33 procedures (6.9%), and perforation of the aneurysm during the coiling occurred in 12 cases (2.5%). Five (41.7%) of 12 patients who had perforation during coiling died. The overall procedure-related morbidity and mortality were 5.6% and 2%, respectively. During the follow-up period, two patients (0.4%) had early rebleeding. None of the patients showed late rebleeding. In the follow-up, the retreatment rate was 12.6%. CONCLUSION Our data confirm the feasibility, safety, and efficacy of endovascular coil embolization in patients with ruptured cerebral aneurysms.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Thirteen-year experience with coil embolization of 481 ruptured intracranial aneurysms: angiographic and clinical results

Dinç

Öztürk²,

Sarı³

et al. 2012

Diagn Interv Radiol

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show abstract

“…2) Furthermore, the rates of aneurysm perforation and thromboembolic events are 2.3% to 4.5% and 8.5% to 12.7%, respectively. 2,3,6,17) Complications related to the endovascular technique occurred in 13 (25.5%) of 51 patients with MCA aneurysms, comprising 3 ruptures and 10 thromboembolisms. 21) Only one intraprocedural rupture and one thromboembolic stroke occurred during the procedure in 30 patients with endovascularly treated MCA aneurysms.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, our results compared favorably to other large series of endovascular surgery for all intracranial aneurysms with morbidity and mortality rates of 4-8.9% and 1.3-4.8%, respectively. 3,5,6,17,20) Angiographic occlusion of MCA aneurysms widely varies. Complete occlusion was achieved in 41.8%, residual neck in 43.6%, and residual aneurysm in 14.6%.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment With Bare Platinum Coils for Middle Cerebral Artery Aneurysms

Oishi

Yoshida

Shimizu

et al. 2009

Neurol. Med. Chir.(Tokyo)

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Middle cerebral artery (MCA) aneurysms often have unfavorable anatomical characteristics preventing successful endovascular occlusion. We reviewed the outcomes of our series of endosaccular embolization of MCA aneurysms using bare platinum coils, angiographic images, and medical records. Immediate and follow-up angiographic results were categorized as complete occlusion, residual neck, and residual flow. Follow-up angiographic changes were categorized as unchanged, minor or major recurrence, and progressive thrombosis. Between December 2001 and August 2007, 112 patients with 113 MCA aneurysms underwent endovascular treatment, of whom 60 presented with subarachnoid hemorrhage (SAH) due to MCA aneurysm rupture. Immediate angiographic outcomes for 103 aneurysms revealed complete occlusion in 64, residual neck in 21, residual flow in 18, and failed embolization in 10. Follow-up angiography of 70 aneurysms demonstrated 41 unchanged, 10 minor recurrences, 12 major recurrences, 7 progressive thromboses, and no bleeding of coil embolized aneurysms. Outcomes of 58 SAH patients treated endovascularly revealed 45 good recovery and moderate disability, 10 severe disability or persistent vegetative state, and 3 deaths. Forty-four of the 45 patients with unruptured aneurysms treated endovascularly had no changes in their neurological status. One of 5 patients with complications had permanent morbidity. For patients with MCA aneurysms suitable for endovascular surgery, bare platinum coil embolization can be performed with acceptable low morbidity and mortality rates, with a lower risk of postprocedural aneurysmal bleeding.

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“…Despite advances in diagnostic and treatment techniques, the prognosis of SAH remains unimproved. Prophylactic treatment by surgical clipping or endovascular coiling of an aneurysm prior to its rupture can reduce mortality and morbidity (Henkes et al 2004; International Study of Unruptured Intracranial Aneurysms Investigators 1998; Raaymakers et al 1998). However, it is costly and timeconsuming to detect unruptured aneurysms by performing periodic screening examinations by magnetic resonance angiography (MRA).…”

Section: Introductionmentioning

confidence: 99%

Association analyses confirming a susceptibility locus for intracranial aneurysm at chromosome 14q23

Mineharu

Inoue

et al. 2008

J Hum Genet

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Previous linkage analyses of intracranial aneurysm (IA) have proposed several genetic susceptibility loci; however, some loci remain contradictory. The objective of this study was to confirm these loci in a Japanese population using allelic and haplotype association analyses. We set high-density single nucleotide polymorphism markers in previously suggested IA loci and conducted an association analysis in 29 cases and 35 controls from a small community in Akita, Japan. Genotyping was carried out using the GeneChip 10 K mapping array, and the association analysis was performed using GeneSpring GT2 software. The result was confirmed in a replication cohort consisting of 237 cases and 253 controls from all over Japan. Only one variant, rs767603, at chromosome 14q23, was significantly associated with IA, both in allelic analysis (p = 0.00017, Bonferroni-corrected p = 0.021) and haplotype analysis (p = 0.00178, Bonferroni-corrected p = 0.048). This association was confirmed in the replication cohort (p = 0.0046 for allelic association, p = 0.0060 for haplotype association). Our findings confirm 14q23 to be a susceptibility locus for intracranial aneurysm.

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Endovascular Coil Occlusion of 1811 Intracranial Aneurysms: Early Angiographic and Clinical Results

Abstract: These data confirm the safety and efficacy of endovascular coil occlusion for patients with intracranial aneurysms.

Cited by 274 publications

References 47 publications

Thirteen-year experience with coil embolization of 481 ruptured intracranial aneurysms: angiographic and clinical results

Thirteen-year experience with coil embolization of 481 ruptured intracranial aneurysms: angiographic and clinical results

Endovascular Treatment With Bare Platinum Coils for Middle Cerebral Artery Aneurysms

Association analyses confirming a susceptibility locus for intracranial aneurysm at chromosome 14q23

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