Repeated Endovascular Coil Occlusion in 350 of 2759 Intracranial Aneurysms: Safety and Effectiveness Aspects

Henkes, Hans; Fischer, Sebastian; Liebig, Thomas; Weber, W.; Reinartz, J; Miloslavski, E.; Kühne, D.

doi:10.1227/01.neu.0000194831.54183.3f

Cited by 112 publications

(95 citation statements)

References 25 publications

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“…This contrasts starkly with our experience and that of other published series, which have reported low rates of complication associated with additional coiling. 6,7 Despite the fact that the series of Henkes et al 9 included a great proportion of large and giant aneurysms in 495 retreatments, only 3.2% of patients had a permanent neurologic deficit and there was 1 death. The series of van Rooij and Sluzewski 7 also included a large proportion of reopened large or giant aneurysms, but they had no complications in 23 retreatments.…”

Section: Discussionmentioning

confidence: 99%

Retreatment of Previously Embolized Cerebral Aneurysms: The Risk of Further Coil Embolization Does Not Negate the Advantage of the Initial Embolization

Renowden¹,

Koumellis²,

Beneš³

et al. 2008

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Retreatment of Previously Embolized Cerebral Aneurysms: The Risk of Further Coil Embolization Does Not Negate the Advantage of the Initial Embolization

Renowden¹,

Koumellis²,

Beneš³

et al. 2008

AJNR Am J Neuroradiol

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“…This makes total occlusion impossible to achieve in certain cases. Also we try to avoid retreatment, which might carry higher risks as shown in the series of Henkes et al 8 The availability of noninvasive MR angiography has allowed close follow-up of recurring aneurysms, enabling us to limit retreatment to growing sacs. In our series most residual aneurysms remained stable after an early recurrence.…”

Section: Aneurysm Recurrencementioning

confidence: 99%

Endovascular coil occlusion of 152 middle cerebral artery aneurysms: initial and midterm angiographic and clinical results

Bracard

Abdel-Kerim²,

Thuillier³

et al. 2010

JNS

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S urgical clipping of MCA aneurysms is usually preferred to EVT. This preference is largely the result of a relatively easy surgical access and unfavorable endovascular approach due to the complex branching pattern of the MCA. As of this writing, no direct comparison between results of endovascular and surgical treatment of MCA aneurysms has been published in the literature, leaving the optimal treatment strategy unclear and choices depending mainly on the practice at the different centers. We therefore considered it important to study procedure-related risks as well as the immediate and midterm angiographic and clinical results after EVT of MCA aneurysms. MethodsFrom October 1992 to October 2001, a total of 940 patients with 1120 cerebral aneurysms were seen in our institute. Of these 940 patients, 202 (21.5%) were found to have MCA aneurysms (a total of 238 [21.3% of all identified aneurysms]). The closing date was chosen to have more than 5 years of follow-up data.Since the first use of detachable coils in our department in October 1992, data pertaining to all patients referred for EVT has been prospectively recorded. These data include: patients' demographic characteristics, mode of presentation, aneurysmal angiographic features, angiographic outcome at immediate post-EVT and follow-up examinations, procedure-related complications, and clinical status, using Hunt and Hess grading (in case of hemorrhage) on admission and GOS scores upon discharge Object. The object of this study was to evaluate the initial and mid-term angiographic and clinical results after endovascular coil occlusion of middle cerebral artery (MCA) aneurysms at the authors' institution.Methods. The authors conducted a retrospective analysis of a consecutive series of 152 MCA aneurysms (73 ruptured) treated by endovascular coiling in 140 patients. Angiographic and clinical data at initial and midterm follow-up as well as procedure-related complications were prospectively registered.Results. At discharge, favorable clinical outcomes (Glasgow Outcome Scale score of 1 or 2) were obtained in 89.3% of patients (125/140). Seven patients (5%) were in a vegetative state or had died. Complications were encountered in association with 11.8% of the procedures (18/152), and most (13/18) involved thromboembolic events (which led to permanent ischemia in 4 cases and death in 1). The overall procedure-related mortality rate was 0.7%, and the rates of permanent and transient morbidity were 2.6 and 2%, respectively. At a mean follow-up duration of 4.3 years there had been 4 cases of rebleeding: early rebleeding occurred during the initial postoperative period in 3 cases and later in 1. Total or subtotal occlusion was obtained in 84.2% of aneurysms (128/152). At follow-up, this satisfactory occlusion persisted in 83.3% of aneurysms (110/132) at 1 year posttreatment, 79.5% (89/112) at 3 years, and 80.2% (73/91) at 5 years.Conclusions. Risks and initial and midterm angiographic and clinical results after endovascular treatment of MCA aneurysms are nearly identi...

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“…Those findings led to the selection of stent-assisted coil embolization instead of surgical management. However, it would still be limited with regard to the perioperative risk of perforation, the potential occurrence of thromboembolic events, the failure of the delivery of the stent into the intended lesion, stenosis, and occlusion of the parent vessel 4,10,14) . A review of previous literature on the outcomes of stent-assisted coil embolization revealed that immediate angiography demonstrated complete occlusion in 35% of cases, neck remnant in 45%, and incomplete occlusion in 20% 1) .…”

Section: Discussionmentioning

confidence: 99%

Stent-Assisted Coil Embolization for the Proximal Middle Cerebral Artery Fusiform Aneurysm

Jeong

Kang

Lee

et al. 2010

J Korean Neurosurg Soc

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J Korean Neurosurg Soc 47 : [406][407][408] 2010 Middle cerebral artery (MCA) fusiform aneurysms often have an unfavorable geometry that may limit surgical or endovascular treatment. Herein, we present a case of a fusiform aneurysm of the proximal MCA, which was successfully treated using stent-assisted coil embolization. A 42-year-old man presented with repeated headache and syncope. Five years earlier, a right MCA aneurysm had been treated by aneurismal wrapping. Magnetic resonance images (MRI) revealed a partially-thrombosed proximal MCA aneurysm at the right perisylvian region. Digital subtraction angiography (DSA) revealed a multilobulated fusiform-shaped aneurysm. The patient underwent stent-assisted coil embolization under general anesthesia and symptoms resolved postoperatively. A three-month follow-up angiography revealed no recanalization of the aneurysm and indicated tolerable blood flow through the right MCA, as compared to the preoperative angiography. We suggest that in selected patients, stent-assisted coil embolization of proximal MCA fusiform aneurysms can be an effective treatment modality.

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Repeated Endovascular Coil Occlusion in 350 of 2759 Intracranial Aneurysms: Safety and Effectiveness Aspects

Cited by 112 publications

References 25 publications

Retreatment of Previously Embolized Cerebral Aneurysms: The Risk of Further Coil Embolization Does Not Negate the Advantage of the Initial Embolization

Retreatment of Previously Embolized Cerebral Aneurysms: The Risk of Further Coil Embolization Does Not Negate the Advantage of the Initial Embolization

Endovascular coil occlusion of 152 middle cerebral artery aneurysms: initial and midterm angiographic and clinical results

Stent-Assisted Coil Embolization for the Proximal Middle Cerebral Artery Fusiform Aneurysm

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