Treatment of Multiple Intracranial Aneurysms with 1-Stage Coiling

Jeon, Pyoung; Kim, Byung Moon; Kim, D. J.; Suh, Sang Hyun

doi:10.3174/ajnr.a3821

Cited by 48 publications

(30 citation statements)

References 19 publications

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“…Procedural details were previously described in the literature [ 16 17 ]. Briefly, all patients with unruptured aneurysms who scheduled coil embolization received dual antiplatelet premedication (aspirin 100 mg and clopidogrel 75 mg) for at least 5 days.…”

Section: Methodsmentioning

confidence: 99%

Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms

Park

Kim

2016

Neurointervention

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PurposeTo compare clinical and angiographic outcomes between balloon-assisted (BAC) and stent-assisted coiling for internal carotid artery unruptured aneurysms (ICA-UA).Materials and MethodsA total of 227 ICA-UA in 190 patients were treated with BAC (120 patients, 141 ICA-UA) or SAC (70 patients, 86 ICA-UA. We compared characteristics of patients and ICA-UA, and clinical and angiographic outcomes between groups.ResultsAneurysm size and neck diameter were greater for SAC than in BAC, but aneurysm volume and coil packing density were not different between groups. Immediate angiographic occlusion grade was better for BAC than for SAC. Periprocedural thromboembolic events were more frequent during SAC (11.6%) than BAC (2.4%) per aneurysm, but hemorrhagic events were the opposite (2.4% for BAC and none for SAC per aneurysm) (p < 0.05). At discharge, treatment-related morbi-mortality rates were 1.6% for BAC and 1.4% per patient for SAC. At clinical follow-up (BAC, 118 patients [98.3%] for a mean of 48.4 months; SAC, 69 patients [98.6%], for a mean of 37.4 months), 1 additional treatment-related infarction occurred during SAC, resulting in a modified Rankin scale score of 4. Thus, overall treatment-related morbi-mortality rates were 1.7% in BAC and 2.9% in SAC. At imaging follow-up (BAC, 135 aneurysms [95.7%] for 28.3 months; SAC, 81 aneurysms [94.1%] for 23.9 months), BAC and SAC showed stable or improved occlusion in 94.1% and 95.0%, minor recurrence in 4.4% and 2.5%, and major recurrence in 1.5% and 2.5%, respectively.ConclusionBoth BAC and SAC were safe and effective techniques for ICA-UA. There were no differences in morbi-mortality and recurrence rates between groups.

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Section: Methodsmentioning

confidence: 99%

Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms

Park

Kim

2016

Neurointervention

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“…And this approach would require multiple stent-assisted procedures that cost more, given current Chinese medical insur-ance and also risk more radiation exposure. 10 Because the seven aneurysms in this case were concentrated around the anterior circulation of the Willis circle and were relatively close to each other, there was a high probability of successful simultaneous clipping of all seven aneurysms. Therefore, surgical clipping via the right extended pterional approach was chosen in this case.…”

Section: Discussionmentioning

confidence: 81%

Single-Stage Clipping of Seven Intracranial Aneurysms in the Anterior Circulation via Unilateral Pterional Approach: A Case Report and Literature Review

Hou

et al. 2020

J Neurol Surg A Cent Eur Neurosurg

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The occurrence of multiple intracranial aneurysms (MIAs) is not rare, with a reported incidence of 15 to 35%. However, patients harboring seven or more intracranial aneurysms are so uncommon that only sporadic cases have ever been reported. We present a rare case with seven intracranial aneurysms (two anterior communicating artery aneurysms, two right middle cerebral artery aneurysms, two left ophthalmic artery aneurysms, and one right ophthalmic artery aneurysm) in the anterior circulation that were simultaneously clipped via the extended right pterional approach. The surgery was uneventful. The patient experienced a rapid postoperative recovery with no neurologic deficits. To our knowledge, this is the first case of seven bilateral intracranial aneurysms that were surgically clipped via unilateral craniotomy. This case showed that in properly selected patients with anterior circulation MIAs, even as many as seven, one-stage clipping can be achieved. Successful clipping of the contralateral ophthalmic aneurysms was the key step in the operation.

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“…In one of the two recent studies with a large patient population, Jeon et al 17 treated 359 aneurysms in 167 patients with three types of combined coiling techniques. In 131 patients (78.4%), all detected aneurysms were treated with coiling only.…”

Section: Discussionmentioning

confidence: 99%

Single-stage endovascular treatment of multiple intracranial aneurysms with combined endovascular techniques: is it safe to treat all at once?

Andıç

Aydemir

Kardeş

et al. 2016

J NeuroIntervent Surg

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Single-stage endovascular treatment of multiple aneurysms with combined endovascular techniques is technically feasible and increases the treatment possibility of all detected aneurysms. However, the safety of the procedure is controversial due to relatively high complication rates. In particular, in patients with bilateral internal carotid artery aneurysms, staged therapy may be used instead of simultaneous treatment with flow diverters to avoid thromboembolic events.

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Treatment of Multiple Intracranial Aneurysms with 1-Stage Coiling

Abstract: BACKGROUND AND PURPOSE:Although multiple intracranial aneurysms are frequent, determining treatment strategy and methods for them is often complicated. The aim of this study was to evaluate the safety and effectiveness of 1-stage coiling for multiple intracranial aneurysms.

Cited by 48 publications

References 19 publications

Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms

Comparison Between Balloon-Assisted and Stent-Assisted Technique for Treatment of Unruptured Internal Carotid Artery Aneurysms

Single-Stage Clipping of Seven Intracranial Aneurysms in the Anterior Circulation via Unilateral Pterional Approach: A Case Report and Literature Review

Single-stage endovascular treatment of multiple intracranial aneurysms with combined endovascular techniques: is it safe to treat all at once?

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