Clinical and angiographic long-term follow-up of completely coiled intracranial aneurysms using endovascular technique
The anatomical evolution and clinical outcome of completely coiled intracranial aneurysms after endovascular embolization have rarely been studied separately. From their prospective database, the authors reviewed follow-up angiography and clinical outcome of 87 patients whose aneurysms were designat...
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| Veröffentlicht in: | Journal of neurosurgery 2010-03, Vol.112 (3), p.575-581 |
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| creator | DAE SEOB CHOI MUN CHUL KIM SEON KYU LEE WILLINSKY, Robert A TERBRUGGE, Karel G |
| description | The anatomical evolution and clinical outcome of completely coiled intracranial aneurysms after endovascular embolization have rarely been studied separately. From their prospective database, the authors reviewed follow-up angiography and clinical outcome of 87 patients whose aneurysms were designated as 100% obliterated on immediate postembolization angiography.
Ninety-one aneurysms (56 ruptured and 35 unruptured) in 87 patients were included in this study. Clinical outcome was evaluated using the Glasgow Outcome Scale. Follow-up angiographic findings were assessed and categorized as 1 of the following: no recanalization, recanalization with a neck remnant, or recanalization with a body remnant. For statistical analysis, the recanalization rate was correlated with: clinical presentation; the largest aneurysm diameter, aneurysm neck size, and dome-to-neck ratio; aneurysm location; and use of special techniques such as usage of a surface modified coil, balloon remodeling technique, or stent.
At the latest clinical evaluation (mean 34.3 months), 81 (93.1%) of the 87 patients (91 aneurysms) had good clinical outcomes (Glasgow Outcome Scale Score 5). The procedure-related morbidity rate (permanent neurological deficit) was 2.3% (2 of 87), and there were no procedure-related deaths. On the latest follow-up angiography (mean 26.4 months), the recanalization rate was 26.4% (24 of 91 aneurysms): 16 (17.6%) with neck remnants and 8 (8.8%) with body remnants. The neck size of the recanalized aneurysms was statistically significantly larger than that of the nonrecanalized aneurysms (p = 0.006), and aneurysms with wide necks (> or = 4 mm) had a higher recanalization rate than those with a narrow neck (< 4 mm) (p = 0.002). There was no bleeding after endovascular treatment during the follow-up period.
Completely coiled aneurysms after endovascular embolization demonstrated good clinical outcome, and there was no bleeding episode after endovascular treatment; however, there was a relatively high recanalization rate. |
| doi_str_mv | 10.3171/2008.12.jns08768 |
| format | Article |
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Ninety-one aneurysms (56 ruptured and 35 unruptured) in 87 patients were included in this study. Clinical outcome was evaluated using the Glasgow Outcome Scale. Follow-up angiographic findings were assessed and categorized as 1 of the following: no recanalization, recanalization with a neck remnant, or recanalization with a body remnant. For statistical analysis, the recanalization rate was correlated with: clinical presentation; the largest aneurysm diameter, aneurysm neck size, and dome-to-neck ratio; aneurysm location; and use of special techniques such as usage of a surface modified coil, balloon remodeling technique, or stent.
At the latest clinical evaluation (mean 34.3 months), 81 (93.1%) of the 87 patients (91 aneurysms) had good clinical outcomes (Glasgow Outcome Scale Score 5). The procedure-related morbidity rate (permanent neurological deficit) was 2.3% (2 of 87), and there were no procedure-related deaths. On the latest follow-up angiography (mean 26.4 months), the recanalization rate was 26.4% (24 of 91 aneurysms): 16 (17.6%) with neck remnants and 8 (8.8%) with body remnants. The neck size of the recanalized aneurysms was statistically significantly larger than that of the nonrecanalized aneurysms (p = 0.006), and aneurysms with wide necks (> or = 4 mm) had a higher recanalization rate than those with a narrow neck (< 4 mm) (p = 0.002). There was no bleeding after endovascular treatment during the follow-up period.
Completely coiled aneurysms after endovascular embolization demonstrated good clinical outcome, and there was no bleeding episode after endovascular treatment; however, there was a relatively high recanalization rate.</description><identifier>ISSN: 0022-3085</identifier><identifier>EISSN: 1933-0693</identifier><identifier>DOI: 10.3171/2008.12.jns08768</identifier><identifier>PMID: 19361261</identifier><identifier>CODEN: JONSAC</identifier><language>eng</language><publisher>Charlottesville, VA: American Association of Neurological Surgeons</publisher><subject>Adolescent ; Adult ; Aged ; Aneurysm, Ruptured - pathology ; Aneurysm, Ruptured - therapy ; Biological and medical sciences ; Cerebral Angiography ; Databases, Factual ; Embolization, Therapeutic - adverse effects ; Embolization, Therapeutic - methods ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm - pathology ; Intracranial Aneurysm - therapy ; Male ; Medical sciences ; Middle Aged ; Neurosurgery ; Prospective Studies ; Severity of Illness Index ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Time Factors ; Treatment Outcome ; Young Adult</subject><ispartof>Journal of neurosurgery, 2010-03, Vol.112 (3), p.575-581</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c283t-c41b6e81635322c45106116e0749c676526f2a7620666ca2bc84064f31cce5fa3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22509354$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19361261$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DAE SEOB CHOI</creatorcontrib><creatorcontrib>MUN CHUL KIM</creatorcontrib><creatorcontrib>SEON KYU LEE</creatorcontrib><creatorcontrib>WILLINSKY, Robert A</creatorcontrib><creatorcontrib>TERBRUGGE, Karel G</creatorcontrib><title>Clinical and angiographic long-term follow-up of completely coiled intracranial aneurysms using endovascular technique</title><title>Journal of neurosurgery</title><addtitle>J Neurosurg</addtitle><description>The anatomical evolution and clinical outcome of completely coiled intracranial aneurysms after endovascular embolization have rarely been studied separately. From their prospective database, the authors reviewed follow-up angiography and clinical outcome of 87 patients whose aneurysms were designated as 100% obliterated on immediate postembolization angiography.
Ninety-one aneurysms (56 ruptured and 35 unruptured) in 87 patients were included in this study. Clinical outcome was evaluated using the Glasgow Outcome Scale. Follow-up angiographic findings were assessed and categorized as 1 of the following: no recanalization, recanalization with a neck remnant, or recanalization with a body remnant. For statistical analysis, the recanalization rate was correlated with: clinical presentation; the largest aneurysm diameter, aneurysm neck size, and dome-to-neck ratio; aneurysm location; and use of special techniques such as usage of a surface modified coil, balloon remodeling technique, or stent.
At the latest clinical evaluation (mean 34.3 months), 81 (93.1%) of the 87 patients (91 aneurysms) had good clinical outcomes (Glasgow Outcome Scale Score 5). The procedure-related morbidity rate (permanent neurological deficit) was 2.3% (2 of 87), and there were no procedure-related deaths. On the latest follow-up angiography (mean 26.4 months), the recanalization rate was 26.4% (24 of 91 aneurysms): 16 (17.6%) with neck remnants and 8 (8.8%) with body remnants. The neck size of the recanalized aneurysms was statistically significantly larger than that of the nonrecanalized aneurysms (p = 0.006), and aneurysms with wide necks (> or = 4 mm) had a higher recanalization rate than those with a narrow neck (< 4 mm) (p = 0.002). There was no bleeding after endovascular treatment during the follow-up period.
Completely coiled aneurysms after endovascular embolization demonstrated good clinical outcome, and there was no bleeding episode after endovascular treatment; however, there was a relatively high recanalization rate.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aneurysm, Ruptured - pathology</subject><subject>Aneurysm, Ruptured - therapy</subject><subject>Biological and medical sciences</subject><subject>Cerebral Angiography</subject><subject>Databases, Factual</subject><subject>Embolization, Therapeutic - adverse effects</subject><subject>Embolization, Therapeutic - methods</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Intracranial Aneurysm - pathology</subject><subject>Intracranial Aneurysm - therapy</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Prospective Studies</subject><subject>Severity of Illness Index</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0022-3085</issn><issn>1933-0693</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kDtPwzAQxy0EoqWwMyEviCnFr1ySEVW8pEosMEeu46SuHDvYSVG_PRYUhtPd8NP_cQhdU7LktKD3jJBySdly5yIpCyhP0JxWnGcEKn6K5oQwlnFS5jN0EeOOEAoC2DmaJQgoAzpH-5U1zihpsXRNms74LshhaxS23nXZqEOPW2-t_8qmAfsWK98PVo_aHtJprG6wcWOQKkhnfmT0FA6xj3iKxnVYu8bvZVSTlQGPWm2d-Zz0JTprpY366rgX6OPp8X31kq3fnl9XD-tMsZKPmRJ0A7qkwHPOmBI5JUApaFKISkEBOYOWyQIYAQAl2UaVgoBoOVVK563kC3T3qzsEn2zjWPcmKm1tiumnWBecQwWC5Ym8OZLTptdNPQTTy3Co_16VgNsjkNpI26a-ysR_jrGcVDwX_BtQoHn8</recordid><startdate>20100301</startdate><enddate>20100301</enddate><creator>DAE SEOB CHOI</creator><creator>MUN CHUL KIM</creator><creator>SEON KYU LEE</creator><creator>WILLINSKY, Robert A</creator><creator>TERBRUGGE, Karel G</creator><general>American Association of Neurological Surgeons</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20100301</creationdate><title>Clinical and angiographic long-term follow-up of completely coiled intracranial aneurysms using endovascular technique</title><author>DAE SEOB CHOI ; MUN CHUL KIM ; SEON KYU LEE ; WILLINSKY, Robert A ; TERBRUGGE, Karel G</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c283t-c41b6e81635322c45106116e0749c676526f2a7620666ca2bc84064f31cce5fa3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aneurysm, Ruptured - pathology</topic><topic>Aneurysm, Ruptured - therapy</topic><topic>Biological and medical sciences</topic><topic>Cerebral Angiography</topic><topic>Databases, Factual</topic><topic>Embolization, Therapeutic - adverse effects</topic><topic>Embolization, Therapeutic - methods</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Intracranial Aneurysm - pathology</topic><topic>Intracranial Aneurysm - therapy</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Prospective Studies</topic><topic>Severity of Illness Index</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DAE SEOB CHOI</creatorcontrib><creatorcontrib>MUN CHUL KIM</creatorcontrib><creatorcontrib>SEON KYU LEE</creatorcontrib><creatorcontrib>WILLINSKY, Robert A</creatorcontrib><creatorcontrib>TERBRUGGE, Karel G</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurosurgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DAE SEOB CHOI</au><au>MUN CHUL KIM</au><au>SEON KYU LEE</au><au>WILLINSKY, Robert A</au><au>TERBRUGGE, Karel G</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Clinical and angiographic long-term follow-up of completely coiled intracranial aneurysms using endovascular technique</atitle><jtitle>Journal of neurosurgery</jtitle><addtitle>J Neurosurg</addtitle><date>2010-03-01</date><risdate>2010</risdate><volume>112</volume><issue>3</issue><spage>575</spage><epage>581</epage><pages>575-581</pages><issn>0022-3085</issn><eissn>1933-0693</eissn><coden>JONSAC</coden><abstract>The anatomical evolution and clinical outcome of completely coiled intracranial aneurysms after endovascular embolization have rarely been studied separately. From their prospective database, the authors reviewed follow-up angiography and clinical outcome of 87 patients whose aneurysms were designated as 100% obliterated on immediate postembolization angiography.
Ninety-one aneurysms (56 ruptured and 35 unruptured) in 87 patients were included in this study. Clinical outcome was evaluated using the Glasgow Outcome Scale. Follow-up angiographic findings were assessed and categorized as 1 of the following: no recanalization, recanalization with a neck remnant, or recanalization with a body remnant. For statistical analysis, the recanalization rate was correlated with: clinical presentation; the largest aneurysm diameter, aneurysm neck size, and dome-to-neck ratio; aneurysm location; and use of special techniques such as usage of a surface modified coil, balloon remodeling technique, or stent.
At the latest clinical evaluation (mean 34.3 months), 81 (93.1%) of the 87 patients (91 aneurysms) had good clinical outcomes (Glasgow Outcome Scale Score 5). The procedure-related morbidity rate (permanent neurological deficit) was 2.3% (2 of 87), and there were no procedure-related deaths. On the latest follow-up angiography (mean 26.4 months), the recanalization rate was 26.4% (24 of 91 aneurysms): 16 (17.6%) with neck remnants and 8 (8.8%) with body remnants. The neck size of the recanalized aneurysms was statistically significantly larger than that of the nonrecanalized aneurysms (p = 0.006), and aneurysms with wide necks (> or = 4 mm) had a higher recanalization rate than those with a narrow neck (< 4 mm) (p = 0.002). There was no bleeding after endovascular treatment during the follow-up period.
Completely coiled aneurysms after endovascular embolization demonstrated good clinical outcome, and there was no bleeding episode after endovascular treatment; however, there was a relatively high recanalization rate.</abstract><cop>Charlottesville, VA</cop><pub>American Association of Neurological Surgeons</pub><pmid>19361261</pmid><doi>10.3171/2008.12.jns08768</doi><tpages>7</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Aneurysm, Ruptured - pathology Aneurysm, Ruptured - therapy Biological and medical sciences Cerebral Angiography Databases, Factual Embolization, Therapeutic - adverse effects Embolization, Therapeutic - methods Female Follow-Up Studies Humans Intracranial Aneurysm - pathology Intracranial Aneurysm - therapy Male Medical sciences Middle Aged Neurosurgery Prospective Studies Severity of Illness Index Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Time Factors Treatment Outcome Young Adult |
| title | Clinical and angiographic long-term follow-up of completely coiled intracranial aneurysms using endovascular technique |
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