Summary
76 consecutive patients with 78 unruptured cerebral aneurysms underwent endovascular therapy from July 1999 to May 2004 in our institute. For the wide-necked aneurysms, the remodeling technique, double microcatheter technique, or stent-assisted coil embolization was used, while a parent artery occlusion or covered stent was applied for the giant or fusiform aneurysms. Immediate angiographical results demonstrated 33 complete occlusions, 26 neck remnants, and 14 dome fillings. Four cases were treated with parent occlusion or stenting only, and one case was not treated with embolization but with clipping due to the rupture of the aneurysm during coil embolization. Immediate angiographic findings demonstrated that in aneurysms between 5 to 10 mm, the rate of complete occlusion was 48%, that of neck remnants 33%, and that of dome fillings 27%. In aneurysms between 11 to 25 mm, the rate of complete occlusion was 14%, that of neck remnants 28%, and that of dome fillings was 58%. In the angiographic follow-up results, all aneurysms smaller than 5 mm showed complete occlusion. In aneurysms between 5 to 10 mm, 74% of the aneurysms showed complete occlusion, and 21% showed neck remnants, and 5% showed dome filling. In aneurysms between 10 to 24 mm, 25% showed complete occlusion, while 75% showed dome filling. The overall mortality rate was 0% and the morbidity rate was 3.7% (2 major strokes, 1 minor stroke) at 30-days after embolization. In the clinical follow-up study, one case of a large basilar tip aneurysm caused a fatal rupture 28 months after the initial embolization. Endovascular therapy was performed on the unruptured aneurysms and was found to be an acceptable treatment, except for durability in cases of large aneurysms.
Keywords
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Bederson JB, Awad IA, Wiebers DO, Piepgras D, Haley EC Jr, Brott T, Hademenos G, Chyatte D, Rosenwasser R, Caroselli C (2000) Recommendations for the management of patients with unruptured intracranial aneurysms: a statement for healthcare professionals from the Stroke Council of the American Heart Association. Stroke 31: 2742–2750
Gonzalez N, Murayama Y, Nien YL, Martin N, Frazee J, Duckwiler G, Jahan R, Gobin YP, Vinuela F (2004) Treatment of unruptured aneurysms with GDCs: clinical experiences with 247 aneurysms. AJNR Am J Neuroradiol 25: 577–583
International Study of Unruptured Intracranial Aneurysms Investigators Unruptured intracranial aneurysms — risk of rupture and risks of surgical intervention (1998). N Engl J Med 339: 1725–1733
Johnston SC, Dudley RA, Gress DR, Ono L (1999) Surgical and endovascular treatment of unruptured cerebral aneurysms at university hospitals. Neurology 52: 1799–1805
Matsumoto H, Terada T, Tsuura M, Itakura T, Ogawa A (2003) Basic fibroblast growth factor released from a platinum coil with a polyvinyl alcohol core enhances cellular proliferation and vascular wall thickness: an in vitro and in vivo study. Neurosurgery 53: 402–408
Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R, International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group (2002) International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 26: 1267–1274
Moret J, Cognard C, Weill A, Castaings L, Rey A (1997) Reconstruction technique in the treatment of wide-neck intracranial aneurysms. Long-term angiographic and clinical results. A propos of 56 cases. J Neuroradiol 24: 30–44
Murayama Y, Vinuela F, Duckwiler GR, Gobin YP, Guglielmi G (1999) Embolization of incidental cerebral aneurysms by using the Guglielmi detachable coil system. J Neurosurg 90: 207–214
Murayama Y, Vinuela F, Tateshima S, Song JK, Gonzalez NR, Wallace MP (2001) Bio-absorbable polymeric material coils for embolization of intracranial aneurysms: a preliminary experimental study. J Neurosurg 94: 454–463
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer-Verlag
About this paper
Cite this paper
Terada, T. et al. (2005). Endovascular treatment of unruptured cerebral aneurysms. In: Yonekawa, Y., Keller, E., Sakurai, Y., Tsukahara, T. (eds) New Trends of Surgery for Stroke and its Perioperative Management. Acta Neurochirurgica Supplements, vol 94. Springer, Vienna. https://doi.org/10.1007/3-211-27911-3_13
Download citation
DOI: https://doi.org/10.1007/3-211-27911-3_13
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-24338-1
Online ISBN: 978-3-211-27911-3
eBook Packages: MedicineMedicine (R0)