Long-term Results of Therapeutic Parent Artery Occlusion without Bypass Surgery for Internal Carotid Artery Aneurysms

Kuramoto, Yoji; Imamura, Hirotoshi; Sakai, Nobuyuki; Adachi, Hidemitsu; Ueno, Yasushi

doi:10.5797/jnet.oa.2016-0105

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…The endovascular PAO of the ICA can be performed effectively with detachable balloons and more recently with micro coils [34]. Kuramoto et al reported successful ICA occlusion of 34 aneurysms of 33 patients with periprocedural ischemia in four patients (12%) [35]. A recent study of PAO for treatment of 17 giant CCA aneurysms, revealed complete occlusion in all patients with periprocedural infarct in 5.9% of cases and there was no mortality [36].…”

Section: Proximal Artery Occlusionmentioning

confidence: 99%

Endovascular Parent Artery Occlusion for Intracranial Aneurysms is a Viable, Cost-Effective Alternative: An Institutional Experience from Northeast India

Phukan

Sarma

Lynser

et al. 2021

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Purpose. Endovascular parent artery occlusion (PAO) may be an alternative approach for complex intracranial aneurysm with potentially life-threatening complications. Moreover, the long-term follow-up of the PAO for an intracranial aneurysm is reported sparingly, limited to the case series. It is therefore important to carry out more research on long-term follow-up of the implication of PAO of intracranial aneurysm. The aim of the study was to analyses our experience of PAO for intracranial aneurysms with emphasis on long-term follow-up.Materials and Methods. The data of patients treated with PAO for intracranial aneurysms were reviewed. The outcome was evaluated based on aneurysmal occlusion on immediate angiography, follow-up magnetic resonance angiography (MRA), and complications. The modified Rankin score (mRS) was used to evaluate the functional outcome during the last follow-up. The mean, range, and standard deviation were reported for other variables – the patient’s age, number, and percentage.Results. Endovascular treatment was performed in 178 patients including PAO in 18 patients. Of these 18 (eighteen) patients, there were 13 dissecting aneurysms, 4 mycotic aneurysms, and one traumatic aneurysm.10 (ten) patients underwent PAO for proximal intracranial artery aneurysm and 8 (eight) patients for distal cerebral aneurysms. Complete occlusion of the aneurysm was achieved in 16patients (88.89%) and retrograde filling of the aneurysm was seen in 2 (11.11%) patients. One patient had intraprocedural coil migration resulting in a major infarct with an mRS of 2. Another patient (5.56%) had recanalization of the aneurysm and presented with rupture and intracranial hemorrhage with an mRS score of 4. The mRS of the other 16 patients (88.89%) was zero.Conclusions. Endovascular PAO for cerebral aneurysms was highly feasible and achieved complete occlusion. The morbidity and mortality rates were at the long-term follow-up also acceptable with negligible complications.

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Section: Proximal Artery Occlusionmentioning

confidence: 99%

Endovascular Parent Artery Occlusion for Intracranial Aneurysms is a Viable, Cost-Effective Alternative: An Institutional Experience from Northeast India

Phukan

Sarma

Lynser

et al. 2021

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Long term stability of patients undergoing endovascular parent artery occlusion of their intracranial artery

Koizumi

Shojima

Ota

et al. 2023

Preprint

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Background: Although endovascular parent artery occlusion (PAO) of the intracranial artery is a well-established treatment option, the long-term stability of cerebral blood flow remains a concern. This study aimed to evaluate the long-term clinical and radiological outcomes of patients who underwent PAO. Methods: The patients who underwent endovascular PAO of their internal carotid or vertebral artery (VA) between April 2011 and March 2022 were included in this observational study. Information about patient characteristics, details of the endovascular treatment, and clinical and radiological follow-up were collected. Results: The study included a total of 104 cases (average age 52.9±12.6 years old, male 73 (70.2%) cases, 95 (91.3%) VA PAO cases) from eight centers. Most cases were performed in an emergency condition, such as ruptured vertebral artery dissecting aneurysm (73 cases [70.2%]). PAO was successful in all cases. Early stroke (within 30 days) occurred in 33 (31.7%) cases (31 cases in VA PAO and two cases in internal carotid PAO) with ischemic stroke (29 cases) comprising the largest group. Clinical follow-up over 12 months was available in 78 cases. During an average follow-up period of 49.5 ± 24.3 months, one case in VA PAO experienced a stroke without functional deterioration. Imaging follow-up was performed in 73 cases. Recanalization of the occluded VA was observed in two cases. The remaining image change was contralateral VA stenosis after VA PAO. The incidence of clinical and radiological events was 0.95 and 1.1% per patient-year, respectively. Conclusions: Once the patients surpass the acute phase after PAO, their mid-to-long term course was stable. The risk of late stroke or de novo aneurysm formation was lower than expected in the literature, and the direct comparison to novel reconstructive techniques is warranted in future studies. Registration: https://www.umin.ac.jp/ctr/index.html, trial ID: UMIN000045160

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Long‐Term Stability of Patients Undergoing Endovascular Parent Artery Occlusion of Their Intracranial Artery

Koizumi,

Shojima,

Ota

et al. 2023

SVIN

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BACKGROUND Although endovascular parent artery occlusion (PAO) of the intracranial artery is a well‐established treatment option, the long‐term stability of cerebral blood flow remains a concern. This study aimed to evaluate the long‐term clinical and radiological outcomes of patients who underwent PAO. METHODS The patients who underwent endovascular PAO of their internal carotid or vertebral artery (VA) between April 2011 and March 2022 were included in this observational study. Information about patient characteristics, details of the endovascular treatment, and clinical and radiological follow‐up were collected. RESULTS The study included a total of 104 cases (average age, 52.9±12.6 years old; men, 73 [70.2%] cases; 95 [91.3%] VA PAO cases) from 8 centers. Most cases were performed in an emergency condition, such as ruptured VA dissecting aneurysm (73 cases [70.2%]). PAO was successful in all cases. Early stroke (within 30 days) occurred in 33 (31.7%) cases (31 cases in VA PAO and 2 cases in internal carotid PAO) with ischemic stroke (29 cases) comprising the largest group. Clinical follow‐up over 1 month was available in 85 cases. During an average follow‐up period of 45.8±25.8 months, 1 case of VA PAO experienced a stroke without functional deterioration. Imaging follow‐up was performed in 75 cases. Recanalization of the occluded VA was observed in 2 cases. The remaining image change was contralateral VA stenosis after VA PAO. The incidence of clinical and radiological events was 1.2% and 1.1% per patient‐year, respectively. CONCLUSION Once the patients surpass the acute phase after PAO, their mid‐ to long‐term course was stable. The risk of late stroke or de novo aneurysm formation was lower than expected in the literature, and the direct comparison to novel reconstructive techniques is warranted in future studies. Clinical Trial Registration information: https://www.umin.ac.jp/ctr/index.html , trial ID: UMIN000045160.

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Long-term Results of Therapeutic Parent Artery Occlusion without Bypass Surgery for Internal Carotid Artery Aneurysms

Cited by 3 publications

References 17 publications

Endovascular Parent Artery Occlusion for Intracranial Aneurysms is a Viable, Cost-Effective Alternative: An Institutional Experience from Northeast India

Endovascular Parent Artery Occlusion for Intracranial Aneurysms is a Viable, Cost-Effective Alternative: An Institutional Experience from Northeast India

Long term stability of patients undergoing endovascular parent artery occlusion of their intracranial artery

Long‐Term Stability of Patients Undergoing Endovascular Parent Artery Occlusion of Their Intracranial Artery

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