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Parent artery occlusion is not obsolete in giant aneurysms of the ICA. Experience with very-long-term follow-up

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

The purpose of this study was to present the long-term clinical and angiographic follow-up (FU) in 26 consecutive patients with giant/large aneurysms (G/LAs) of the internal carotid artery (ICA) treated by parent artery occlusion (PAO).

Methods

Twenty-two of 26 G/LAs of the ICA were treated by PAO when a balloon test occlusion prior to occlusion of the ICA was tolerated. Clinical and angiographic FU were available in, respectively, 20 and 18 patients with a mean delay of 6.1 years (range 1.5–11).

Results

At long-term FU, clinical symptoms had disappeared in 75% of the patients, partially regressed in 10%, and remained unchanged in 15% of cases. No patient presented worsening of clinical symptoms or intracranial bleeding. Fifteen patients presented a modified Rankin scale score of 0 and five patients a score of 1. On imaging FU, persistent occlusion of the PA was observed in 17/18 cases. One case of aneurysmal recanalization was observed at long-term FU. PAO was well tolerated in all patients. On angiographic FU, no new lesion was detected, except the growing of a pre-existing aneurysm located on the carotid siphon contralateral to the occluded vessel.

Conclusion

Our study demonstrates that occlusion of the parent artery for giant/large ICA aneurysms remains a safe and effective technique with good clinical and angiographic outcome at long-term FU.

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Abbreviations

G/LAs:

Giant/large aneurysms

ICA:

Internal carotid artery

FU:

Follow-up

BTO:

Balloon test occlusion

PAO:

Parent artery occlusion

CN:

Cranial nerve

SAH:

Subarachnoid hemorrhage

IEL:

Internal elastic lamina

mRS:

Modified Rankin scale

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Acknowledgements

We thank Dr David Seidenwurm for the english editing of our work.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, Paris VI University, 47 Bd de l’Hôpital, 75013, Paris, France

    Frédéric Clarençon, Fabrice Bonneville & Alessandra Biondi

  2. Department of Neuroradiology, Hôpital Rangueil. 1, avenue Jean Poulhès University, Hospital of Toulouse, 31000, Toulouse, France

    Fabrice Bonneville

  3. Department of Neurosurgery, Pitié-Salpêtrière Hospital, Paris, France

    Anne-Laure Boch

  4. Department of Intensive Care, Pitié-Salpêtrière Hospital, Paris, France

    Lise Lejean

  5. Department of Neuroradiology, Hôpital Jean Minjoz. 3, bd Alexandre Fleming. University, Hospital of Besançon, 25030, Besançon, France

    Alessandra Biondi

  6. 12, rue Dugommier, 75012, Paris, France

    Frédéric Clarençon

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  1. Frédéric Clarençon
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  2. Fabrice Bonneville
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Correspondence to Frédéric Clarençon.

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Clarençon, F., Bonneville, F., Boch, AL. et al. Parent artery occlusion is not obsolete in giant aneurysms of the ICA. Experience with very-long-term follow-up. Neuroradiology 53, 973–982 (2011). https://doi.org/10.1007/s00234-010-0800-8

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