Epidemiology, genetic, natural history and clinical presentation of giant cerebral aneurysms

Lonjon, M.; Pennes, F.; Sédat, Jacques; Bataille, B.

doi:10.1016/j.neuchi.2015.08.003

Cited by 44 publications

(42 citation statements)

References 59 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 10 , 11 Untreated GIAs have over 50% risk in rupturing and 88% to 100% in mortality at 2-year follow-up. 12 , 13 Due to their volumetric characteristics, the mass effect alone can cause intracranial hypertension and neurological dysfunctions.…”

Section: Different Types Of Iasmentioning

confidence: 99%

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Lin²,

et al. 2017

View full text Add to dashboard Cite

Intracranial aneurysm is a leading cause of stroke. Its treatment has evolved over the past 2 decades. This review summarizes the treatment strategies for intracranial aneurysms from 3 different perspectives: open surgery approach, transluminal treatment approach, and new technologies being used or trialed. We introduce most of the available treatment techniques in detail, including contralateral clipping, wrapping and clipping, double catheters assisting coiling and waffle-cone technique, and so on. Data from major trials such as Analysis of Treatment by Endovascular approach of Non-ruptured Aneurysms (ATENA), Internal Subarachnoid Trial (ISAT), Clinical and Anatomical Results in the Treatment of Ruptured Intracranial Aneurysms (CLARITY), and Barrow Ruptured Aneurysm Trial (BRAT) as well as information from other clinical reports and local experience are reviewed to suggest a clinical pathway for treating different types of intracranial aneurysms. It will be a valuable supplement to the current existing guidelines. We hope it could help assisting real-time decision-making in clinical practices and also encourage advancements in managing the disease.

show abstract

Section: Different Types Of Iasmentioning

confidence: 99%

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Lin²,

et al. 2017

View full text Add to dashboard Cite

show abstract

“…There are higher incidences of fusiform and giant aneurysms in the pediatric population. 12,18,20 Hence, pediatric aneurysms are more likely to be suitable for flow diversion compared with those in adults. However, because there are fundamental differences between intracranial aneurysms in adults and children, it has been proposed that the results of cerebral flow diversion may not be readily applicable to children.…”

Section: Discussionmentioning

confidence: 99%

“…For aneurysm treatment, flow diverters were deployed using previously described techniques [12][13][14] after meticulous measurement of the parent artery size at the proximal and distal segments of the aneurysm. These measurements were made on DSA images and 3D images reconstructed from rotational angiograms on workstations of biplane angiography units (Artis zee; Siemens, Erlangen, Germany).…”

Section: General Description Of the Endovascular Proceduresmentioning

confidence: 99%

Flow Diverters in the Treatment of Pediatric Cerebrovascular Diseases

Barburoğlu

Arat

2016

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

“…This high incidence of aneurysm rupture at presentation highlights the tendency for a much more aggressive natural history of large and giant paraclinoid aneurysms when compared with their smaller counterparts. 5,45,51,72 Not infrequently, large and giant aneurysms are partially thrombosed at the time of diagnosis and present at least a theoretical risk of thromboembolic ischemia due to the dislodgement of small thrombotic fragments into the distal intracranial circulation. Despite this belief, our systematic review showed a relatively low incidence of transient ischemic attacks (TIAs) or ischemic strokes at the time of presentation (2.7%).…”

Section: Pooled Analysis Of the Literaturementioning

confidence: 99%

The 25th anniversary of the retrograde suction decompression technique (Dallas technique) for the surgical management of paraclinoid aneurysms: historical background, systematic review, and pooled analysis of the literature

Flores¹,

White

Batjer

et al. 2019

Journal of Neurosurgery

View full text Add to dashboard Cite

OBJECTIVE Paraclinoid internal carotid artery (ICA) aneurysms frequently require temporary occlusion to facilitate safe clipping. Brisk retrograde flow through the ophthalmic artery and cavernous ICA branches make simple trapping inadequate to soften the aneurysm. The retrograde suction decompression (RSD), or Dallas RSD, technique was described in 1990 in an attempt to overcome some of those treatment limitations. A frequent criticism of the RSD technique is an allegedly high risk of cervical ICA dissection. An endovascular modification was introduced in 1991 (endovascular RSD) but no studies have compared the 2 RSD variations. METHODS The authors performed a systematic review of MEDLINE/PubMed and Web of Science and identified all studies from 1990-2016 in which either Dallas RSD or endovascular RSD was used for treatment of paraclinoid aneurysms. A pooled analysis of the data was completed to identify important demographic and treatment-specific variables. The primary outcome measure was defined as successful aneurysm obliteration. Secondary outcome variables were divided into overall and RSD-specific morbidity and mortality rates. RESULTS Twenty-six RSD studies met the inclusion criteria (525 patients, 78.9% female). The mean patient age was 53.5 years. Most aneurysms were unruptured (56.6%) and giant (49%). The most common presentations were subarachnoid hemorrhage (43.6%) and vision changes (25.3%). The aneurysm obliteration rate was 95%. The mean temporary occlusion time was 12.7 minutes. Transient or permanent morbidity was seen in 19.9% of the patients. The RSD-specific complication rate was low (1.3%). The overall mortality rate was 4.2%, with 2 deaths (0.4%) attributable to the RSD technique itself. Good or fair outcome were reported in 90.7% of the patients. Aneurysm obliteration rates were similar in the 2 subgroups (Dallas RSD 94.3%, endovascular RSD 96.3%, p = 0.33). Despite a higher frequency of complex (giant or ruptured) aneurysms, Dallas RSD was associated with lower RSD-related morbidity (0.6% vs 2.9%, p = 0.03), compared with the endovascular RSD subgroup. There was a trend toward higher mortality in the endovascular RSD subgroup (6.4% vs 3.1%, p = 0.08). The proportion of patients with poor neurological outcome at last follow-up was significantly higher in the endovascular RSD group (15.4% vs 7.2%, p < 0.01). CONCLUSIONS The treatment of paraclinoid ICA aneurysms using the RSD technique is associated with high aneurysm obliteration rates, good long-term neurological outcome, and low RSD-related morbidity and mortality. Review of the RSD literature showed no evidence of a higher complication rate associated with the Dallas technique compared with similar endovascular methods. On a subgroup analysis of Dallas RSD and endovascular RSD, both groups achieved similar obliteration rates, but a lower RSD-related morbidity was seen in the Dallas technique subgroup. Twenty-five years after its initial publication, RSD remains a useful neurosurgical technique for the management of large and giant parac...

show abstract

Epidemiology, genetic, natural history and clinical presentation of giant cerebral aneurysms

Cited by 44 publications

References 59 publications

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Current Treatment Strategies for Intracranial Aneurysms: An Overview

Flow Diverters in the Treatment of Pediatric Cerebrovascular Diseases

The 25th anniversary of the retrograde suction decompression technique (Dallas technique) for the surgical management of paraclinoid aneurysms: historical background, systematic review, and pooled analysis of the literature

Contact Info

Product

Resources

About