Journal of neuroradiology = Journal de neuroradiologie · 2018
Endovascular treatment of distal anterior cerebral artery aneurysms: Long-term results.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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История · было → стало
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Liao Liang, Derelle Anne-Laure, Merlot Isabelle, Civit Thierry, Audibert Gérard, Tonnelet Romain, Gory Benjamin, Anxionnat René, Bracard Serge
Аннотация
BACKGROUND AND PURPOSE: Endovascular therapy is the first-line therapeutic option for intracranial aneurysms, however the results of the endovascular approach for distal anterior cerebral artery (DACA) aneurysms are not well-known. We assessed the immediate and long-term clinical and angiographic outcomes after endovascular coiling of DACA aneurysms.
MATERIALS AND METHODS: We performed a retrospective analysis of all consecutive DACA aneurysms treated by endovascular coiling. Procedural complications, clinical, and angiographic results were prospectively recorded in an institutional aneurysm database between 1992 and 2013.
RESULTS: Satisfactory initial occlusion was achieved for 85.9% of cases (79/92). There were three cases of intraprocedural rupture of the aneurysmal sac and three treatment failures, all involving small aneurysms (< 4 mm). Rates of procedure-related mortality and morbidity were respectively 1.1% and 0%. Scores of 5 (good recovery) or 4 (moderate disability) on the Glasgow Outcome Scale, indicating favorable outcome, were observed for 79.3% of patients (73/92) at hospital discharge. In follow-up, 13 cases of recanalization were observed, 12 of which were classified as major. Ten of the recanalizations underwent a complementary intervention.
CONCLUSIONS: The endovascular management of DACA aneurysms appears to be efficacious and safe, although certain technical difficulties may emerge when aneurysms are small. A higher proportion of major recanalization events may imply a more frequent deployment of complementary interventions in comparison to aneurysms situated elsewhere.
MATERIALS AND METHODS: We performed a retrospective analysis of all consecutive DACA aneurysms treated by endovascular coiling. Procedural complications, clinical, and angiographic results were prospectively recorded in an institutional aneurysm database between 1992 and 2013.
RESULTS: Satisfactory initial occlusion was achieved for 85.9% of cases (79/92). There were three cases of intraprocedural rupture of the aneurysmal sac and three treatment failures, all involving small aneurysms (< 4 mm). Rates of procedure-related mortality and morbidity were respectively 1.1% and 0%. Scores of 5 (good recovery) or 4 (moderate disability) on the Glasgow Outcome Scale, indicating favorable outcome, were observed for 79.3% of patients (73/92) at hospital discharge. In follow-up, 13 cases of recanalization were observed, 12 of which were classified as major. Ten of the recanalizations underwent a complementary intervention.
CONCLUSIONS: The endovascular management of DACA aneurysms appears to be efficacious and safe, although certain technical difficulties may emerge when aneurysms are small. A higher proportion of major recanalization events may imply a more frequent deployment of complementary interventions in comparison to aneurysms situated elsewhere.