Noninvasive follow-up of GDC-treated saccular aneurysms by MR angiography

Weber, W.; Yousry, Tarek; Felber, Stephan; Henkes, Hans; Nahser, H. C.; Roer, N; Kühne, D.

doi:10.1007/s003300000741

Cited by 39 publications

(19 citation statements)

References 9 publications

(16 reference statements)

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“…It has been reported that the sensitivity of MRA ranged from 0.76 to 0.98 32 and 0.92 with consensus reading. 33 We estimated sensitivity as 0.9 in this study, expecting that 1 or 2 of the 12 unaffected persons might be misclassified. To evaluate this uncertainty, linkage analyses with only affected members were conducted.…”

Section: Discussionmentioning

confidence: 99%

Absence of Linkage of Familial Intracranial Aneurysms to 7q11 in Highly Aggregated Japanese Families

Yamada

Utsunomiya²,

Inoue³

et al. 2003

Stroke

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Background and Purpose-We sought to test the linkage of familial intracranial aneurysms (FIAs) to the ELN (elastin) locus in chromosome 7q11 reported previously. Methods-Intracranial aneurysm (IA) probands were searched from patient records or neurosurgeons' recalls in collaborating hospitals. Members of the participating probands' families who had unknown affection status were screened by MR angiography and diagnosed by digital subtraction angiography. Inclusion criteria of families for genetic analyses were as follows: at least 3 alive affected members or 2 alive affected members with at least 1 unaffected member (Ն60 years). Linkage to the ELN locus was tested with the use of GENEHUNTER by parametric and nonparametric methods. To exclude false-negatives in the linkage analysis, the lowest 5% limits of logarithms of the odds (LOD) and nonparametric LOD (NPL) scores for individual families and for the total set of families were simulated on assumption that the ELN locus is linked to FIAs. Results-Questionnaires were sent to 885 patients, and 563 responded. Seventy-nine probands were positive for family history. One hundred thirty-four family members of unknown affection status were screened. A total of 14 families with 64 members met the criteria. Linkage to the ELN locus was discarded in 11 families and was inconclusive for 3 families. The total LOD and total NPL scores for 14 families were Ϫ8.04 and Ϫ0.643, respectively. Our conclusion did not change even when the values of penetrance were changed or only affected members were analyzed. Conclusions-The majority of aggregated IA Japanese families may not have a genetic linkage to chromosome 7q11.(Stroke. 2003;34:892-900.)

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Section: Discussionmentioning

confidence: 99%

Absence of Linkage of Familial Intracranial Aneurysms to 7q11 in Highly Aggregated Japanese Families

Yamada

Utsunomiya²,

Inoue³

et al. 2003

Stroke

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“…However, iterative invasive angiography may have adverse effects, and the required duration of close surveillance remains to be determined. 36) Noninvasive MR angiography is currently limited due to metallic artifacts, 46) but advances in MR techniques, the study of large series, and long follow-up periods may increase the usefulness of this modality for the monitoring of such aneurysms.…”

Section: Relationships Of Aneurysm Size and Location To Outcomementioning

confidence: 99%

Endovascular Treatment of Asymptomatic Cerebral Aneurysms: Anatomic and Technical Factors Related to Ischemic Events and Coil Stabilization

Soeda

Sakai

et al. 2004

Neurol. Med. Chir.(Tokyo)

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The present study assessed the safety and efficacy of embolization using Guglielmi detachable coils (GDCs) in 100 asymptomatic cerebral aneurysms classified as sidewall (70) or terminal (30) aneurysms according to the parent artery (68 small aneurysms with a small neck, 21 small aneurysms with a wide neck, and 11 large aneurysms). A balloon-assisted technique was used in 49 aneurysms. Immediate angiography revealed that 71 aneurysms were completely obliterated. Transient deficits occurred in 19 patients, permanent deficits in four patients, and one patient died. Most complications occurred during or immediately after treatment and resolved within a few minutes to a few weeks. None of the surviving patients manifested significant morbidity at 1-year follow up. Follow-up angiographic study was performed in 79 aneurysms. Rates of recanalization and progressive thrombosis (total occlusion of the residual aneurysm at follow up) were 11% and 38%, respectively, in sidewall aneurysms, and 26% and 0%, respectively, in terminal aneurysms. Treatment with GDCs was effective for patients with small aneurysms with small necks, the morbidity was acceptable, and progressive thrombosis occurred during the follow-up period. GDC treatment achieved unsatisfactory results in patients with small terminal aneurysms with wide necks and in large aneurysms, because the obliteration rate was low, and the recanalization and complication rates were high. Multivariate analysis showed that complete occlusion was associated with small-necked aneurysms, and ischemic events tended to occur in terminal aneurysms and in aneurysms treated by the balloon-assisted technique.

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“…In dem für die Verlaufskontrolle wichtigsten Punkt, der Frage nach der Rekanalisation bzw. Reperfusion des Aneurysmas, geben verschiedene Autoren Sensitivitäten zwischen 72,7% und 92% sowie Spezifitäten zwischen 90,9% und 100% [1,4,5,16,26,27,32] an. Im Vergleich hierzu lagen die Sensitivität und Spezifität im eigenen Patientengut bei 90% bzw.…”

Section: Introductionunclassified

MRA versus DSA zur Verlaufskontrolle endovaskulär und mikrochirurgisch behandelter intrakranieller Aneurysmen

Hochmuth

Vougioukas

Ziyeh

et al. 2004

Klinische Neuroradiolgie

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ZusammenfassungHintergrund und Ziel: Nach endovaskulärer Therapie von intrakraniellen Aneurysmen sind Kontrolluntersuchungen erforderlich, um -bei inkompletter Ausschaltung -rechtzeitig eine Reintervention zu ermöglichen oder -bei vollständiger Ausschaltung -den Behandlungserfolg in zeitlichem Abstand zu bestätigen. Ziel dieser retrospektiven Studie war der Vergleich zwischen digitaler Subtraktionsangiographie (DSA) und Time-of-Flight-Magnetresonanzangiographie (MRA) zur Verlaufskontrolle endovaskulär oder mikrochirurgisch behandelter intrakranieller Aneurysmen. Patienten und Methodik: Zwischen Mai 1998 und Oktober 2003 wurden bei 62 Patienten mit 73 behandelten Aneurysmen 96 MRA-und 76 DSA-Untersuchungen durchgeführt, um die Verschlussrate zu beurteilen und behandlungsbedürftige Änderungen zu erkennen. DSA und MRA wurden mit maximal 1 Woche Abstand durchgeführt. Ergebnisse: 51 von 73 Aneurysmen waren endovaskulär behandelt worden (davon zwei später geclippt und damit aus der endovaskulären Gruppe ausgeschieden). Vier waren schlecht beurteilbar und wiesen Artefakte auf. 45 von 49 (91,8%) waren gut oder ausreichend zu beurteilen. Restfluss oder der Verdacht darauf wurde bei 20 Aneurysmen festgestellt, was sich in 19 Fällen in der DSA bestätigen ließ. Sieben Aneurysmen waren teilthrombosiert, was die Auswertung der MRA in zwei Fällen beeinträchtigte. Sensitivität und Spezifität des Nachweises von Restfluss bzw. Restaneurysma betrugen 90% bzw. 93,5%. Von den 24 Aneurysmen nach Clipping waren in der MRA nur zwei beurteilbar, 22 wiesen schwere Artefakte auf. Schlussfolgerung: Nach Coiling ist die MRA in der Lage, sowohl den kompletten Verschluss eines Aneurysmas als auch Problemfälle, wie Restperfusion, unvollständig protegierter Hals oder Coilkompaktierung im Aneurysma, zu zeigen. Ist eine Basisuntersuchung verfügbar, die den direkten Vergleich zwischen MRA und DSA gestattet, sind weitere Kontrolluntersuchungen von Aneursymen nach Coiling auch mittels MRA möglich. Aufgrund der Metallartefakte nach Clipping sind hier in der Regel Kontrollen nur mittels DSA möglich.Schlüsselwörter: MRA · DSA · SAB · Aneurysma · Endovaskulär · Verlaufskontrolle Abstract Purpose: To evaluate the reliability of time-of-flight magnetic resonance angiography (MRA) in comparison to digital subtraction angiography (DSA) in the follow-up of endovascular and surgically treated ruptured intracranial aneurysms. Patients and Methods: Between May 1998 and October 2003, 62 patients with 73 treated aneurysms underwent 96 MRA and 76 DSA examinations to assess the occlusion rate and/or recurrence of coiled or clipped aneurysms. DSA and MRA were performed within 1 week. seinem 60. Geburtstag gewidmet.Hochmuth A, et al. Therapiekontrolle intrakranieller Aneurysmen mit MRA vs. DSA Einleitung Seit der Einführung durch Guglielmi et al. 1991 hat sich die Aneurysmatherapie mit endovaskulär platzierbaren Platincoils als Alternative zur operativen Therapie mittels Clipping etabliert [11,12]. Neben zahlreichen Fallserien bzw. kleineren Studien favorisieren die e...

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Noninvasive follow-up of GDC-treated saccular aneurysms by MR angiography

Cited by 39 publications

References 9 publications

Absence of Linkage of Familial Intracranial Aneurysms to 7q11 in Highly Aggregated Japanese Families

Absence of Linkage of Familial Intracranial Aneurysms to 7q11 in Highly Aggregated Japanese Families

Endovascular Treatment of Asymptomatic Cerebral Aneurysms: Anatomic and Technical Factors Related to Ischemic Events and Coil Stabilization

MRA versus DSA zur Verlaufskontrolle endovaskulär und mikrochirurgisch behandelter intrakranieller Aneurysmen

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