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Research ArticleInterventional

Endovascular Treatment of 300 Consecutive Middle Cerebral Artery Aneurysms: Clinical and Radiologic Outcomes

A.M. Mortimer, M.D. Bradley, P. Mews, A.J. Molyneux and S.A. Renowden
American Journal of Neuroradiology April 2014, 35 (4) 706-714; DOI: https://doi.org/10.3174/ajnr.A3776
A.M. Mortimer
aFrom the Department of Neuroradiology, Frenchay Hospital, Bristol, United Kingdom.
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M.D. Bradley
aFrom the Department of Neuroradiology, Frenchay Hospital, Bristol, United Kingdom.
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P. Mews
aFrom the Department of Neuroradiology, Frenchay Hospital, Bristol, United Kingdom.
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A.J. Molyneux
aFrom the Department of Neuroradiology, Frenchay Hospital, Bristol, United Kingdom.
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S.A. Renowden
aFrom the Department of Neuroradiology, Frenchay Hospital, Bristol, United Kingdom.
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Tables

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    Table 1:

    Descriptive data for the study population

    Patient CharacteristicsType of Aneurysm
    UnrupturedRuptured
    Number of patients (n = 295)53242
    Number of aneurysms (n = 300)56244
    Mean (SD) age (y)52.7 (9.6)53.9 (12.4)
    Median (IQR) age (y)55.0 (13.5)53.0 (17)
    Age range (y)29–7221–84
    No. of women (%)38 (73.1)158 (65.3)
    WFNS scale, n (%)
        1−136 (56.2)
        2−38 (15.6)
        3−25 (10)
        4−21 (8.6)
        5−22 (9.1)
    Fisher grade, n (%)
        I−11 (4.5)
        II−20 (8.3)
        III−103 (42.6)
        IV−108 (44.6)
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    Table 2:

    Initial coiling results

    Initial Angiographic ResultUnruptured Aneurysms (n = 56)Ruptured Aneurysms (n = 244)Total (n = 300)
    Complete occlusion29186215 (71.7%)
    Neck remnant174259 (19.7%)
    Aneurysm remnant369 (3.0%)
    Technical failure5813 (4.3%)
    Complication precluding coiling112 (0.7%)
    Missing data112 (0.7%)
    • View popup
    Table 3:

    Complications and subsequent clinical outcomes

    ComplicationAneurysm RuptureThromboembolicEarly RebleedOtherTotal
    Total number (%)15 (5.0)18 (6)3 (1.2)2 (0.7)38 (12.9)
    Clinically silent (%)66214 (4.7)
    GOS 5710219
    GOS 4527
    GOS 1 (%)36312 (4)
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    Table 4:

    Clinical outcomes for patients with ruptured MCA aneurysms

    Clinical OutcomePatients
    GOS 5 (%)170 (70.3)
    GOS 4 (%)23 (9.5)
    GOS 3 (%)15 (6.2)
    GOS 20
    GOS 1 (%)33 (13.6)
    Missing data (%)1 (0.4)
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    Table 5:

    Angiographic outcomes at initial follow-up

    CharacteristicComplete OcclusionNeck RemnantAneurysm RemnantRe-treatment
    All aneurysms (n = 219)148 (67.6%)53 (23.3%)18 (8.1%)13 (5.9%)
    Ruptured aneurysms (n = 175)117421613
    Unruptured aneurysms (n = 44)311120
        Small (≤10 mm)13726116
        Large (11–24 mm)92666
        Giant (≥25 mm)2111
        Wide-neck (>4 mm)2924107
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American Journal of Neuroradiology: 35 (4)
American Journal of Neuroradiology
Vol. 35, Issue 4
1 Apr 2014
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Cite this article
A.M. Mortimer, M.D. Bradley, P. Mews, A.J. Molyneux, S.A. Renowden
Endovascular Treatment of 300 Consecutive Middle Cerebral Artery Aneurysms: Clinical and Radiologic Outcomes
American Journal of Neuroradiology Apr 2014, 35 (4) 706-714; DOI: 10.3174/ajnr.A3776

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Endovascular Treatment of 300 Consecutive Middle Cerebral Artery Aneurysms: Clinical and Radiologic Outcomes
A.M. Mortimer, M.D. Bradley, P. Mews, A.J. Molyneux, S.A. Renowden
American Journal of Neuroradiology Apr 2014, 35 (4) 706-714; DOI: 10.3174/ajnr.A3776
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