RT Journal Article
SR Electronic
T1 Endovascular Coil Embolization of Aneurysms with a Branch Incorporated into the Sac
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 145
OP 151
DO 10.3174/ajnr.A1785
VO 31
IS 1
A1 B.M. Kim
A1 S.I. Park
A1 D.J. Kim
A1 D.I. Kim
A1 S.H. Suh
A1 T.H. Kwon
A1 H.S. Choi
A1 Y.S. Won
YR 2010
UL http://www.ajnr.org/content/31/1/145.abstract
AB BACKGROUND AND PURPOSE: Because of the concern for occlusion of the incorporated branch artery, an aneurysm with a branch incorporated into the sac has been regarded as a contraindication for coiling. The aim of this study is to evaluate the feasibility, techniques, and clinical and angiographic outcomes of coiling for aneurysms with a branch incorporated into the sac. MATERIALS AND METHODS: The medical records and radiologic studies of 69 patients with 79 aneurysms having a branch incorporated into the sac (26 ruptured, 53 unruptured) were retrospectively reviewed and evaluated. RESULTS: Coiling was accomplished in 78 aneurysms in 68 patients but was suspended in 1 due to incorporated branch occlusion. The aneurysms were treated by using the following techniques: single-catheter (n = 37), multicatheter (n = 22), balloon-remodeling (n = 7), stent-assisted coiling (n = 6), and combined (n = 7). Postembolization angiography revealed the following: near-complete occlusion in 71 (89.8%), remnant neck in 4 (5.1%), and incomplete occlusion in 4 (5.1%) aneurysms. Procedure-related permanent morbidity and mortality rates were 5.8% (4/69) and 0%, respectively. All patients with unruptured aneurysms had a modified Rankin Scale (mRS) score of 0, except for 1 patient who had an mRS score of 3. Of the 26 patients with ruptured aneurysms, 18 had favorable outcome (mRS 0–2) but 8 had poor outcome (mRS 3–6). Follow-up angiography was available at least once at 6–50 months (mean, 15 months) in 55 aneurysms (69.6%), of which 45 showed stable or improved occlusion; 4, minor recurrences; and 6, major recurrences. All 6 major recurrent aneurysms were retreated without complication by using a single-catheter (n = 1), multicatheter (n = 2), or balloon-assisted technique (n = 3). CONCLUSIONS: With appropriate techniques, most aneurysms with a branch incorporated into the sac could be safely treated by coiling, with acceptable outcomes.