Partially thrombosed intracranial aneurysms: symptoms, evolution, and therapeutic management

Roccatagliata, Luca; Guédin, Pierre; Condette–Auliac, S.; Gaillard, Stéphan; Colas, F.; Boulin, A.; Wang, Adrien; Guieu, S.; Rodesch, Georges

doi:10.1007/s00701-010-0772-9

Cited by 47 publications

(33 citation statements)

References 28 publications

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“…7 Partially thrombosed intracranial aneurysms mostly (60%-91%) present with symptoms of mass effect. 2,8,9 In comparison, embolic phenomena are infrequent. 9 Several patients had nonspecific symptoms, with headache being most common.…”

Section: Discussionmentioning

confidence: 99%

“…9,10 Meanwhile, a few other small case series found these aneurysms to be much less vulnerable to recanalization (approximately 30%) following coil embolization. 2,8 They also reported relief of symptoms and stabilization of the clinical evolution of the disease after coiling. Surgery was ruled out in our patients with aneurysms in the posterior circulation, due to their location, size, and circumferential thrombus.…”

Section: 289mentioning

confidence: 91%

“…Partially thrombosed intracranial aneurysms have a low propensity to bleed, and following treatment, SAH is almost unknown. 1,2,8,9 Even exclusive coil embolization delivers this favorable effect. On the contrary, our case series seems to suggest that exclusive endosaccular treatment with the WEB has an unfavorable impact on the natural history of this disease.…”

Section: 289mentioning

confidence: 99%

“…1 Nonetheless, there is some evidence that exclusive endosaccular coiling can stabilize the disease process, provide clinical recovery, and reduce the mass effect in some patients. 2,3 Besides coil embolization, in recent years, intrasaccular flow disruption with the Woven EndoBridge aneurysm embolization system (WEB; Sequent Medical, Aliso Viejo, California) has emerged as a safe and efficient endosaccular technique for treating intracranial aneurysms. 4 However, literature on its role in the management of partially thrombosed intracranial aneurysm is scarce.…”

mentioning

confidence: 99%

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WEB in Partially Thrombosed Intracranial Aneurysms: A Word of Caution

Gopinathan

Goddard²,

Ross

et al. 2015

American Journal of Neuroradiology

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SUMMARY:Despite the proved safety and efficacy of Woven EndoBridge (WEB) flow disruption in conventional intracranial saccular aneurysms, the literature on its use in partially thrombosed intracranial aneurysms is scarce. We report a series of 4 patients in whom partially thrombosed intracranial aneurysms were treated with the WEB. The 2 patients who received additional intraluminal treatment with conventional stents made a good clinical recovery. Meanwhile, those patients who were treated with the WEB alone had fatal rupture of the aneurysm at short-to medium-term follow-up. This small, select case series demonstrates that WEB placement with adjunctive stent placement may be an effective treatment in the management of partially thrombosed intracranial aneurysms, which merits further validation. However, exclusive intrasaccular flow disruption may have an adverse influence on the natural history of this disease.

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Section: Discussionmentioning

confidence: 99%

Section: 289mentioning

confidence: 91%

Section: 289mentioning

confidence: 99%

mentioning

confidence: 99%

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WEB in Partially Thrombosed Intracranial Aneurysms: A Word of Caution

Gopinathan

Goddard²,

Ross

et al. 2015

American Journal of Neuroradiology

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“…6,7 Previous MR imaging studies have revealed important morphologic features in these aneurysms, which are only partially assessable by DSA. 8,9 Better delineation and characterization of GAs may help to improve our comprehension of the distinct pathophysiology of this rare aneurysm subgroup. The purpose of this study was to assess GAs and their wall microstructure by 7T MR imaging, previously only visualized in histopathologic examinations.…”

Section: 3mentioning

confidence: 99%

Giant Intracranial Aneurysms at 7T MRI

Matsushige

Chen

Ringelstein

et al. 2015

AJNR Am J Neuroradiol

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SUMMARY: Giant intracranial aneurysms are rare vascular pathologies associated with high morbidity and mortality. The purpose of this in vivo study was to assess giant intracranial aneurysms and their wall microstructure by 7T MR imaging, previously only visualized in histopathologic examinations. Seven giant intracranial aneurysms were evaluated, and 2 aneurysms were available for histopathologic examination. Six of 7 (85.7%) showed intraluminal thrombus of various sizes. Aneurysm walls were depicted as hypointense in TOF-MRA and SWI sequences with excellent contrast ratios to adjacent brain parenchyma (range, 0.01-0.60 and 0.58 -0.96, respectively). The triple-layered microstructure of the aneurysm walls was visualized in all aneurysms in TOF-MRA and SWI. This could be related to iron deposition in the wall, similar to the findings in 2 available histopathologic specimens. In vivo 7T TOF-MRA and SWI can delineate the aneurysm wall and the triple-layered wall microstructure in giant intracranial aneurysms. ABBREVIATIONS:GA ϭ giant intracranial aneurysm; SEM ϭ standard error of the mean

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