Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding

Byrne, James; Sohn, Min-Joo; Molyneux, Andrew; Chir, B.

doi:10.3171/jns.1999.90.4.0656

Cited by 407 publications

(67 citation statements)

References 47 publications

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“…Nevertheless, the rate was considerably higher than the previously reported risk of SAH in the normal population (<0.03% per year) [10], and therefore the patients with ruptured cerebral aneurysms still carry higher long-term risks for SAH even after complete obliteration of the aneurysm. In coil embolization for ruptured intracranial aneurysms, the annual rebleeding rate was reported to be 0.8% in the first year, 0.6% in the 2nd year, and 2.4% in the 3rd year after embolization [11]. …”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Recurrent Intracranial Aneurysms

Nakase

Kamada²,

Aoki³

et al. 2000

Cerebrovasc Dis

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The authors report 11 cases who underwent reoperations upon for recurrent aneurysms. The initial operations were performed on average 10.1 years earlier for subarachnoid hemorrhage (SAH). The patients’ mean age at the first surgery was 39.7 years. The locations were 9 internal carotid (IC)-posterior communicating artery (PC) and 2 anterior communicating artery (A-com) aneurysms. A residual aneurysmal neck after the first operation was observed in 3 of 10 cases confirmed by postoperative angiography. The primitive-type PC artery was seen in 8 of 9 recurrent IC-PC aneurysms. The recurrent manifestations were SAH in 9 cases. Clipping operations were conducted in 10 and ligation of the IC artery together with extracranial-intracranial bypass in 1 large IC-PC aneurysm. The present study demonstrated two risk factors for aneurysm recurrence, namely, young age and IC-PC aneurysms with a primitive-type PC. Furthermore, direct operation for recurrent aneurysm is often embarassing due to adhesions to the surrounding tissue as a sequela of the previous operation, hence understanding of the anatomical correlation between the old clip and the recurrent portion is important.

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Section: Discussionmentioning

confidence: 99%

Clinical Study on Recurrent Intracranial Aneurysms

Nakase

Kamada²,

Aoki³

et al. 2000

Cerebrovasc Dis

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“…A cohort study [24], aimed at comparing the clinical outcomes of surgical clipping and embolization at 60 university hospitals in the USA, found that patients who received coil embolization (10.6%) had fewer adverse outcomes (i.e., death or move to a nursing home or rehabilitation institution at discharge) than those treated with surgery (18.5%). Although obliteration of aneurysms by embolization has been shown to achieve comparable mortality and morbidity in the management of aneurysmal subarachnoid hemorrhage, aneurysm recurrence after embolization is significantly high [25, 26]. …”

Section: Introductionmentioning

confidence: 99%

Neuropsychological Sequelae of Patients Treated with Microsurgical Clipping or Endovascular Embolization for Anterior Communicating Artery Aneurysm

Chan

Poon

2002

Eur Neurol

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Background and Purpose: While microsurgical clipping has been the choice of treatment for anterior communicating artery (ACoA) aneurysm, endovascular embolization is increasingly popular for treating intracranial aneurysms. Previous studies showed that in terms of mortality (i.e., death) and morbidity (i.e., functional outcome, independent living, rebleeding) rates, the clinical outcomes of coil embolization for intracranial aneurysms are as good as or even better than those of surgical clipping. However, little is known about the impact of these treatments on the cognitive functions of those survived after the treatment. Thus, the present study is designed to examine the cognitive deficits of patients treated with either surgical clipping or coil embolization. Method: Eighteen patients with a ruptured ACoA aneurysm were recruited. Half of them had undergone surgical clipping and the other half had endovascular embolization. Standardized neuropsychological tests were employed to assess their memory, executive function, motor ability, language and visual perceptual abilities. Results: The performance of the patients was in general poorer than that of the normal control subjects on tests of verbal memory, flexible thinking, ability to resist interference and motor control. However, in terms of severity, the patients who received surgical clipping demonstrated more severe impairment than those had endovascular embolization on these cognitive domains. In addition, while 33% of patients in the clipping group showed impairments on memory and executive function, no patient in the embolization group demonstrated these impairments. Conclusions: Patients with ACoA aneurysm demonstrated impaired verbal memory, executive function and motor abilities while their language and visual perception abilities remained relatively intact. However, when comparing the effect of treatment choice on the cognitive functions of these patients, the present results favored the coil embolization as the patients treated with coil embolization demonstrated significantly fewer severe cognitive deficits than patients who had undergone surgical clipping.

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“…Aneurysms with a complex shape, acute angles with the parent vessel, or those with wide necks are a therapeutic challenge for interventionists, with a much higher risk of recurrence [3,4,5,6]. In cases of wide-necked cerebral aneurysms, selective embolization is challenging due to the risk of coil protrusion into the parent artery.…”

Section: Introductionmentioning

confidence: 99%

“…This has made the use of BACE a more prevalent and preferable approach by clinicians in the last several years to treat wide-necked intracranial aneurysms [3,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. Balloons have also been shown to help in the tamponade of the vessel in case of intraoperative perforation [22,23] and are also used for occlusion testing before sacrifice of the vessel.…”

Section: Introductionmentioning

confidence: 99%

Early Experience with the TransForm™ Occlusion Balloon Catheter: A Single-Center Study

et al. 2014

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Background and Objective: Balloon-assisted coil embolization has become an important adjunct in the endovascular treatment of intracranial aneurysms. The management of broad-necked cerebral aneurysms is technically perplexed due to a variety of factors, which include the difficulty in defining the aneurysm-parent vessel interface angiographically and problems in achieving complete aneurysmal occlusion. This could later predispose to regrowth or recanalization. We sought to determine the safety and efficacy of the TransForm™ occlusion balloon catheter (TOBC) for the coiling of intracranial aneurysms at our institute. Methods: A retrospective review was performed to identify TOBC cases between May 1, 2013, and April 30, 2014. Results: A total of 24 TOBC cases were identified. In 23 cases, the TOBC was used for balloon-remodeled coil embolization, and in 1 case, it was used for vasospasm treatment alone. Out of the total 24 cases in which the TOBC was used, 16 (66.6%) were ruptured aneurysms. Stents were used in 6/23 (26%) cases. In all cases, the balloon could be placed as intended. The inflation and deflation times ranged from 3 to 4 s. No serious complications were noted. In the experience of the authors, the balloon performed the intended role in most cases. Conclusions: This series shows that the TOBC is feasible, safe and useful in the treatment of cerebral aneurysms. The balloon was traceable to the intended site and the preparation, inflation and deflation times were short. We believe that the TOBC has effective utility in treating broad-necked and small aneurysms.

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Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding

Abstract: Periodic follow-up angiography after coil embolization is recommended to identify aneurysm recurrence and those patients at a high risk of late rebleeding.

Cited by 407 publications

References 47 publications

Clinical Study on Recurrent Intracranial Aneurysms

Clinical Study on Recurrent Intracranial Aneurysms

Neuropsychological Sequelae of Patients Treated with Microsurgical Clipping or Endovascular Embolization for Anterior Communicating Artery Aneurysm

Early Experience with the TransForm™ Occlusion Balloon Catheter: A Single-Center Study

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