Parent Artery Occlusion in Large, Giant, or Fusiform Aneurysms of the Carotid Siphon: Clinical and Imaging Results

Labeyrie, Marc Antoine; Lenck, Stéphanie; Bresson, D.; Desilles, Jean‐Philippe; Bisdorff, Annouk; Saint-Maurice, J.-P.; Houdart, E

doi:10.3174/ajnr.a4064

Cited by 35 publications

(19 citation statements)

References 21 publications

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“…We never encountered persistent aneurysm filling through collaterals via the ophthalmic artery. The effectiveness of our protocol of ICA balloon occlusion proximal to the aneurysm is comparable with the protocol of trapping the aneurysm with coils used by Labeyrie et al 19 However, we are in favor of our protocol because it is much easier to perform and definitely much cheaper. In addition, trapping in aneurysms located close to the ICA bifurcation is not possible because the distal ICA segment is too short to accommodate the coils.…”

Section: Discussionmentioning

confidence: 57%

“…Because long-term imaging follow-up studies after flow-diverter treatment of ICA aneurysms are not yet available, complication rates may be underestimated: delayed in-stent occlusion may go clinically undetected in the three-fourths of patients who can tolerate ICA occlusion. 30 In our opinion, supported by others, 19 the safety profile of flow diverters is not good enough to justify treatment of ICA aneurysms in patients who can tolerate carotid occlusion, especially not in patients with cavernous aneurysms that generally exhibit a benign natural history.…”

Section: Discussionmentioning

confidence: 79%

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Therapeutic Internal Carotid Artery Occlusion for Large and Giant Aneurysms: A Single Center Cohort of 146 Patients

Bechan

Majoie

Sprengers

et al. 2015

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: At our institution, patients with large or giant ICA aneurysms are preferably treated with endovascular ICA balloon occlusion. Alternative treatment or conservative treatment is offered only for patients who cannot tolerate permanent ICA occlusion. In this observational study, we report the clinical and imaging results of ICA occlusion for aneurysms in a large single-center patient cohort.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 79%

Therapeutic Internal Carotid Artery Occlusion for Large and Giant Aneurysms: A Single Center Cohort of 146 Patients

Bechan

Majoie

Sprengers

et al. 2015

AJNR Am J Neuroradiol

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“…In a series of 56 consecutive patients receiving PAO for the treatment of large/giant aneurysms of the carotid siphon, Labeyrie et al [22] demonstrated an aneurysm retraction rate of 91% and a procedure-related permanent morbidity rate of 5%. Twenty-six percent of the patients in the Labeyrie series [22] suffered ischemic events, with symptoms resolving in most patients. Other series report ischemic stroke rates of 5-15% for PAO of ICA aneurysms with permanent occlusion rates of 90-100% [23,24,25].…”

Section: Discussionmentioning

confidence: 99%

“…While the rates of permanent aneurysm occlusion and procedure-related morbidity rates in the above series are similar to those of large and giant aneurysms in PUFS, it is important to emphasize that PAO techniques can only be used in patients who can tolerate occlusion of the carotid artery. By preserving parent artery flow, flow diverters such as the PED can be used in the treatment of patients in both the presence and absence of collateral flow [22]. …”

Section: Discussionmentioning

confidence: 99%

Aneurysm Study of Pipeline in an Observational Registry (ASPIRe)

et al. 2016

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Background and Objective: Few prospective studies exist evaluating the safety and efficacy of the Pipeline Embolization Device (PED) in the treatment of intracranial aneurysms. The Aneurysm Study of Pipeline In an observational Registry (ASPIRe) study prospectively analyzed rates of complete aneurysm occlusion and neurologic adverse events following PED treatment of intracranial aneurysms. Materials and Methods: We performed a multicenter study prospectively evaluating patients with unruptured intracranial aneurysms treated with PED. Primary outcomes included (1) spontaneous rupture of the Pipeline-treated aneurysm; (2) spontaneous nonaneurysmal intracranial hemorrhage (ICH); (3) acute ischemic stroke; (4) parent artery stenosis, and (5) permanent cranial neuropathy. Secondary endpoints were (1) treatment success and (2) morbidity and mortality at the 6-month follow-up. Vascular imaging was evaluated at an independent core laboratory. Results: One hundred and ninety-one patients with 207 treated aneurysms were included in this registry. The mean aneurysm size was 14.5 ± 6.9 mm, and the median imaging follow-up was 7.8 months. Twenty-four aneurysms (11.6%) were small, 162 (78.3%) were large and 21 (10.1%) were giant. The median clinical follow-up time was 6.2 months. The neurological morbidity rate was 6.8% (13/191), and the neurological mortality rate was 1.6% (3/191). The combined neurological morbidity/mortality rate was 6.8% (13/191). The most common adverse events were ischemic stroke (4.7%, 9/191) and spontaneous ICH (3.7%, 7/191). The complete occlusion rate at the last follow-up was 74.8% (77/103). Conclusions: Our prospective postmarket study confirms that PED treatment of aneurysms in a heterogeneous patient population is safe with low rates of neurological morbidity and mortality. Patients with angiographic follow-up had complete occlusion rates of 75% at 8 months.

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“…n their recent publication "Parent Artery Occlusion in Large, Giant, or Fusiform Aneurysms of the Carotid Siphon: Clinical and Imaging Results," Labeyrie et al 1 retrospectively reviewed 56 patients treated with aneurysm trapping by using detachable platinum coils. The authors make 2 controversial statements, neither of which is referenced, and with which we take issue:…”

mentioning

confidence: 99%