Surgery following endovascular coiling of intracranial aneurysms

Thornton, John; Dovey, Zach; Alazzaz, Abdulkader; Misra, Mukesh; Aletich, Victor; Debrun, Gérard; Ausman, James I.; Charbel, Fady T.

doi:10.1016/s0090-3019(00)00337-2

Cited by 91 publications

(68 citation statements)

References 15 publications

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“…[4][5][6][7][8] This study demonstrated that similar symptoms were observed in PCS, 3,4) and similar leukocytosis was also observed in PCS 10) ( Table 4). Recent studies have suggested that the etiology of PES is related to an inflammatory process/cascade and tissue ischemia and necrosis although there are some differences in blood flow preservation between PCS and PES.…”

Section: Discussionsupporting

confidence: 81%

“…It is reasonable to consider, however, that the placement of numerous coils into the cerebral artery may cause an inflammatory reaction or dural irritation. 3,4) The inflammatory response is known to participate in the biological processes of endothelialization. Some studies have reported that the aneurysmal wall becomes disorganized by the invasion of capillaries and fibroblasts that organize the thrombotic material and initiate a foreign body reaction in the neighborhood of the coils after coil embolization.…”

Section: Disclosure Statementmentioning

confidence: 99%

“…1) Unidentified fever, headache, and gastrointestinal symptoms are occasionally observed after endosaccular coil embolization in patients with unruptured cerebral aneurysms. 2,3) Little is known about these symptoms following endosaccular coil embolization.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Analysis of Fever, Headache, and Gastrointestinal Symptoms after Endosaccular Coil Embolization in Patients with Unruptured Cerebral Aneurysms— A Study of “Post Coiling Syndrome”

Okuma

Sugiu

Tokunaga

et al. 2016

JNET

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Objective: Unidentified fever, headache, and gastrointestinal symptoms after endosaccular coil embolization are occasionally observed in patients with unruptured cerebral aneurysms. We defined these symptoms as post coiling syndrome (PCS) and analyzed the clinical risk factors involved. Methods:We applied the PCS diagnostic criteria based on the scoring of symptoms, which include fever, headache, nausea, and/or vomiting. Thirty-six consecutive patients were included in this retrospective study. Systematic follow-up included clinical and blood examinations.Results: Based on our criteria, 11 of 36 patients were diagnosed with PCS. Between patients in the PCS group and patients in the non-PCS group, we recognized significant differences in age (63.4 ± 12.5 vs. 53.8 ± 12.9, respectively; p <0.029) as patient background and in aneurysmal diameter (9.96 ± 4.24 vs. 6.48 ± 3.06, respectively; p <0.049), aneurysmal volume (242 ± 254 vs. 87.9 ± 70.1, respectively; p <0.015), total coil length (122 ± 106 vs. 39.1 ± 25.7, respectively; p <0.0021), and volume embolization ratio as aneurysmal data (41.9 ± 8.1 vs. 30.7 ± 8.5, respectively; p <0.0019). In addition, we recognized a significant difference in postoperative leukocytosis as an inflammatory factor. Conclusions:Patient age, aneurysmal diameter, aneurysmal volume, total coil length, and volume embolization may enable the prediction of PCS.

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Section: Discussionsupporting

confidence: 81%

Section: Disclosure Statementmentioning

confidence: 99%

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Clinical Analysis of Fever, Headache, and Gastrointestinal Symptoms after Endosaccular Coil Embolization in Patients with Unruptured Cerebral Aneurysms— A Study of “Post Coiling Syndrome”

Okuma

Sugiu

Tokunaga

et al. 2016

JNET

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“…A recanalização dos aneurismas, após o tratamento por GDC e que necessitam de tratamento complementar, não é rara, com porcentagens variáveis [4][5][6][7][8][9][10][11][12][13]15,[18][19][20][21][22] . Em nossa série de aneurismas rotos, tratados por GDC, encontramos 33,3% de tratamento incompleto.…”

Section: Discussionunclassified

“…Outros 6,12 , preconizam acompanhamento do resíduo até o momento em que o colo do aneurisma fique livre do material, facilitando a clipagem. Nossa opinião é que a retirada dos coils nem sempre é simples, devido a presença do trombo intra-aneurismá-tico e a forte aderência do material à parede do vaso, principalmente se a embolização foi realizada após algumas semanas, podendo levar a ruptura vascular catastrófica.…”

Section: Discussionunclassified

Estudo comparativo entre aneurismas rotos tratados por cirurgia e por via endovascular

Conrad

Pélissou-Guyotat

Morel

et al. 2002

Arq. Neuro-Psiquiatr.

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RESUMO -Realizamos análise comparativa dos resultados clínicos e radiológicos após o tratamento de aneurisma roto, localizado no setor anterior, por cirurgia ou por via endovascular. Entre 1995 e 1999, 78 pacientes foram tratados em nosso serviço por apresentarem ruptura de aneurisma intracraniano com grau clínico (Hunt & Hess) variando entre I e III. Dentre estes pacientes, 52 foram operados, 21 embolizados e 5 fizeram tratamento combinado. Dos casos cirúrgicos, o resultado clínico foi considerado ótimo em 80,8% com mortalidade de 5% e oclusão completa do aneurisma em 96,2%. Dos pacientes embolizados, 95% dos casos o resultado foi considerado ótimo com oclusão completa do aneurisma em 42,8%. O tratamento endovascular de aneurismas intracranianos apresenta uma vantagem no resultado clínico em relação aos aneurismas operados. Porém, apresentam taxa de exclusão completa baixa e podem necessitar de tratamento complementar. PALAVRAS-CHAVES: aneurismas intracranianos, repermeabilização, cirurgia após embolização.Comparative study for ruptured aneurysms treated by surgery and endovascular method Comparative study for ruptured aneurysms treated by surgery and endovascular method Comparative study for ruptured aneurysms treated by surgery and endovascular method Comparative study for ruptured aneurysms treated by surgery and endovascular method Comparative study for ruptured aneurysms treated by surgery and endovascular method ABSTRACT -The management of intracranial aneurysms has truly evolved after the introduction of the endovascular treatment. In this paper we compare patients that were operated or embolized for intracranial aneurysms. Between 1995 and 1999, 78 grade I to III ruptured aneurysms were treated in our service: 52 patients were operated, 21 were embolized and 5 were submitted to combinated endovascular and surgical treatment. In the surgical group, clinical outcome was very good in 80.8% of cases with 5% of mortality with 96.2% of total exclusion of the aneurysm. In the endovascular group, 95% of cases the clinical outcome was very good with only 42.8% of total exclusion of the aneurysm. By the endovascular method for treatment of aneurysms, we can obtain a good clinical outcome but a poor radiological outcome and sometimes need a complementary surgical procedure to treat residual aneurysm. O manejo dos aneurismas intracranianos e suas complicações tem evoluido após a introdução do tratamento endovascular por Guglielmi Detachable Coils (GDC) na década de 90. Este método é uma opção alternativa para os casos de difícil acesso cirúr-gico. Os resultados do tratamento cirúrgico dos aneurismas tem melhorado após a aplicação de técnicas microscópicas e do tratamento clínico e cirúrgico precoces após a sua ruptura 1,2 . As técnicas do tratamento endovascular têm evoluido muito nestes úl-timos anos, após os primeiros relatos de Serbinenko em 19743 . Isto conduziu a ampla utilização da téc-nica no tratamento dos aneurismas intracranianos, até mesmo em casos em que uma clipagem cirúrgi-ca seria possível, devido ao...

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Surgical indications and techniques for failed coiled aneurysms

Raftopoulos

Vaz

2011

Advances and Technical Standards in Neurosurgery

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For two decades, endovascular coiling has revolutionized the treatment of intracranial aneurysms. However, as with all techniques, it has limitations and endovascular radiologists and neurosurgeons are regularly confronted by what we call "failed" coiled aneurysms. Failed coiled aneurysms can occur in different situations: a) presence of a significant remnant at the end of an endovascular procedure; b) recanalization of an initially satisfactory occlusion; and c) coil extrusion deemed too thrombogenic or threatening the blood flow in the parent vessel. We and other teams around the world have developed strategies to manage these difficult cases. Here, we compare our own experience with other reports in the literature.

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Surgery following endovascular coiling of intracranial aneurysms

Cited by 91 publications

References 15 publications

Clinical Analysis of Fever, Headache, and Gastrointestinal Symptoms after Endosaccular Coil Embolization in Patients with Unruptured Cerebral Aneurysms— A Study of “Post Coiling Syndrome”

Clinical Analysis of Fever, Headache, and Gastrointestinal Symptoms after Endosaccular Coil Embolization in Patients with Unruptured Cerebral Aneurysms— A Study of “Post Coiling Syndrome”

Estudo comparativo entre aneurismas rotos tratados por cirurgia e por via endovascular

Surgical indications and techniques for failed coiled aneurysms

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