Simple Coiling versus Stent-Assisted Coiling of Paraclinoid Aneurysms : Radiological Outcome in a Single Center Study

Kim, Soo Yeon; Park, Dong Sun; Park, Hye Yin; Chun, Young Il; Moon, Chang Taek; Roh, Hong Gee

doi:10.3340/jkns.2017.0193

Cited by 12 publications

(5 citation statements)

References 32 publications

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“…Stent-assisted coiling is commonly used in the treatment of unruptured, wide-necked aneurysms. The deployment of a stent prevents the coil from protruding into the parent artery and may thus reduce the recurrence rate ( 16 , 17 ). However, the deployment of a stent in the acute stage may incur additional complications, such as in-stent thrombosis ( 7 , 18 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

Safety and effectiveness of double microcatheter technique in the treatment of ruptured aneurysms of anterior cerebral circulation

et al. 2022

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ObjectiveTo evaluate the safety and effectiveness of the double microcatheter technique in the treatment of ruptured aneurysms of the anterior cerebral circulation.MethodsBetween 2012 and 2019, 113 patients with ruptured aneurysms of the anterior cerebral circulation were treated using the double microcatheter technique. Clinical records, angiographic results, and procedure-related complications were reviewed. Clinical and angiographic follow-up was performed.ResultsComplete occlusion, neck remnant, and partial occlusion were, respectively, recorded in 56.6, 38.9, and 4.4% of the total cases. For all patients, the incidence of intraoperative complications was 5.3% (6/113), and the overall rate of morbidity was 10.6% (12/113). Before discharge, three patients (2.7%) died. There was no procedure-related mortality. At discharge, favorable outcomes were observed in 79.6% (90/113) of the patients. High Hunt-Hess grades and receiving a craniotomy or external ventricular drainage were risk factors for clinical outcomes at discharge. Clinical follow-up was performed in 91 patients at a mean interval of 14.07 ± 11.68 months. At follow-up, favorable outcomes were observed in 92.3% (84/91) of the patients. Angiographic follow-up was performed in 66 patients at an average of 11.53 ± 11.13 months. The recurrence rate was 37.9%. Of these patients, 13 (19.7%) received retreatment.ConclusionThe double microcatheter technique can be performed in ruptured aneurysms with high technical success and low morbidity/mortality. However, recurrence remains a problem, and patients should be followed up regularly.

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Section: Discussionmentioning

confidence: 99%

Safety and effectiveness of double microcatheter technique in the treatment of ruptured aneurysms of anterior cerebral circulation

et al. 2022

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“…Previous reports of LPAs only involved treatment studies of all paraclinoid aneurysms 4 , 13 , 23) or small surgical case series. 12) A key finding of the present study was that ICA angle is a hemodynamic factor that contributes to aneurysm morphology.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are only a few reports of aneurysms with a dome projecting laterally and the neck originating from the lateral wall of the paraclinoid potion of the internal carotid artery (ICA). 4 , 12 , 13) These aneurysms are of the sidewall-type, occur at non-branching sites that do not have perforating vessels, and have an orifice located on the lesser curve side of the ICA bend at the level of the anterior clinoid process. The level of hemodynamic stress on the aneurysm can change depending on the degree of lateral flexion of the ICA as the parent artery, which may have a hemodynamic effect on aneurysm morphology and occlusion status after endovascular treatment.…”

Section: Introductionmentioning

confidence: 99%

Endovascular Treatment for Lateral Wall Paraclinoid Aneurysms and the Influence of Internal Carotid Artery Angle

Sugiyama

Fujii

Yatomi

et al. 2021

Neurol. Med. Chir.(Tokyo)

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Lateral wall paraclinoid aneurysms (LPA) are a rare type of aneurysm located on the lesser curve side of the internal carotid artery (ICA) bend, at the level of the anterior clinoid process. The objective of this study was to assess the influence of flexion of the ICA on the morphology of aneurysms and outcome of endovascular treatment. Between 2003 and 2018, we treated 643 cases of unruptured paraclinoid aneurysms with endovascular therapy in our institution. Of those cases, aneurysms projecting laterally on preoperative angiography were defined as LPA. The degree of bending of the ICA (ICA angle) was measured and statistically analyzed in relation to the aneurysm characteristics and the occlusion status after treatment. In all, 43 aneurysms were identified. ICA angle was positively correlated with the maximum dome size of the aneurysm ( P <0.01) and the aspect ratio ( P <0.01), and negatively correlated with the volume coil embolization ratio ( P <0.01). Complete occlusion (CO) was achieved in 23 cases (53.5%) immediately after treatment, and in 35 cases (81.4%) at follow-up. The mean ICA angle in the incomplete occlusion group was significantly larger than in the CO group ( P = 0.01). Larger ICA angle resulted in recurrence, whereas smaller ICA angle was more likely to obtain progressive thrombosis ( P = 0.02). Endovascular treatment for LPA was safe and effective. The degree of flexion of the ICA may contribute to the level of hemodynamic stress on the aneurysm, its morphology, and the embolization effect.

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“…The deployment of stent can protect coil from protruding into parent artery. Additionally, it can reduce the recurrence rate [16][17]. However, the deployment of stent in acute stage may incur more complications such as instent thrombosis [7,18,19].…”

Section: Clinical Outcomesmentioning

confidence: 99%

Endovascular treatment of ruptured aneurysms in anterior cerebral circulation with double microcatheter technique

Zhao¹,

Liu²,

Wang³

et al. 2020

Preprint

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Purpose Single coiling may be the optimal strategy for ruptured aneurysms. But assisted techniques may be needed in some aneurysms. The authors report their experience of double microcatheter technique in the treatment of ruptured aneurysms in anterior cerebral circulation. Methods Between 2012 and 2018, 82 patients with ruptured aneurysms in anterior cerebral circulation were treated with double microcatheter technique. The clinical records, angiographic results, procedure-related complications were reviewed. Clinical and angiographic follow-up was performed. Results Completely occlusion, neck remnant and partial occlusion were achieved in 56.6%, 36.1% and 7.2% in the whole procedures, respectively. The overall rate of morbidity was 8.5% (7/82). The rate of permanent morbidity was 3.7% (3/82). Three patients (3.7%) died before discharge. There was no procedure-related mortality. The favorable outcomes were obtained in 75.6% (62/82) of the whole patients at discharge. High Hunt-Hess grade and suffering from craniotomy or EVD were risk factors for clinical outcomes at discharge. Sixty-eight patients received clinical follow-up at a mean interval of 15.75±12.71 months. Favorable outcomes were obtained in 61 (89.7%) patients. Angiographic follow-up was performed in 44 patients at an average of 13.16±13.12 months. The recurrence rate is 34.1%. Seven of them (15.9%) received retreatment. Conclusion Double microcatheter technique is a safe and effective method for treatment of ruptured aneurysms in anterior cerebral aneurysms with low morbidity. Recurrence remains a problem. Patients should be followed up regularly.

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Simple Coiling versus Stent-Assisted Coiling of Paraclinoid Aneurysms : Radiological Outcome in a Single Center Study

Cited by 12 publications

References 32 publications

Safety and effectiveness of double microcatheter technique in the treatment of ruptured aneurysms of anterior cerebral circulation

Safety and effectiveness of double microcatheter technique in the treatment of ruptured aneurysms of anterior cerebral circulation

Endovascular Treatment for Lateral Wall Paraclinoid Aneurysms and the Influence of Internal Carotid Artery Angle

Endovascular treatment of ruptured aneurysms in anterior cerebral circulation with double microcatheter technique

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