Endovascular treatment of asymptomatic cerebral aneurysms: Anatomic and technical factors related to ischemic events and coil stabilization

Akio Soeda, Nobuyuki Sakai, Hideki Sakai, Koji Iihara, Izumi Nagata

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

The present study assessed the safety and efficacy of embolization using Guglielmi detachable coils (GDCs) in 100 asymptomatic cerebral aneurysms classified as sidewall (70) or terminal (30) aneurysms according to the parent artery (68 small aneurysms with a small neck, 21 small aneurysms with a wide neck, and 11 large aneurysms). A balloon-assisted technique was used in 49 aneurysms. Immediate angiography revealed that 71 aneurysms were completely obliterated. Transient deficits occurred in 19 patients, permanent deficits in four patients, and one patient died. Most complications occurred during or immediately after treatment and resolved within a few minutes to a few weeks. None of the surviving patients manifested significant morbidity at 1-year follow up. Follow-up angiographic study was performed in 79 aneurysms. Rates of recanalization and progressive thrombosis (total occlusion of the residual aneurysm at follow up) were 11% and 38%, respectively, in sidewall aneurysms, and 26% and 0%, respectively, in terminal aneurysms. Treatment with GDCs was effective for patients with small aneurysms with small necks, the morbidity was acceptable, and progressive thrombosis occurred during the follow-up period. GDC treatment achieved unsatisfactory results in patients with small terminal aneurysms with wide necks and in large aneurysms, because the obliteration rate was low, and the recanalization and complication rates were high. Multivariate analysis showed that complete occlusion was associated with small-necked aneurysms, and ischemic events tended to occur in terminal aneurysms and in aneurysms treated by the balloon-assisted technique.

Original languageEnglish
Pages (from-to)456-465
Number of pages10
JournalNeurologia medico-chirurgica
Volume44
Issue number9
DOIs
Publication statusPublished - Sep 1 2004

Fingerprint

Intracranial Aneurysm
Aneurysm
Therapeutics
Neck
Thrombosis
Morbidity

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Endovascular treatment of asymptomatic cerebral aneurysms : Anatomic and technical factors related to ischemic events and coil stabilization. / Soeda, Akio; Sakai, Nobuyuki; Sakai, Hideki; Iihara, Koji; Nagata, Izumi.

In: Neurologia medico-chirurgica, Vol. 44, No. 9, 01.09.2004, p. 456-465.

Research output: Contribution to journalArticle

@article{1a950d4179a040a6bad10bc68cb3f933,
title = "Endovascular treatment of asymptomatic cerebral aneurysms: Anatomic and technical factors related to ischemic events and coil stabilization",
abstract = "The present study assessed the safety and efficacy of embolization using Guglielmi detachable coils (GDCs) in 100 asymptomatic cerebral aneurysms classified as sidewall (70) or terminal (30) aneurysms according to the parent artery (68 small aneurysms with a small neck, 21 small aneurysms with a wide neck, and 11 large aneurysms). A balloon-assisted technique was used in 49 aneurysms. Immediate angiography revealed that 71 aneurysms were completely obliterated. Transient deficits occurred in 19 patients, permanent deficits in four patients, and one patient died. Most complications occurred during or immediately after treatment and resolved within a few minutes to a few weeks. None of the surviving patients manifested significant morbidity at 1-year follow up. Follow-up angiographic study was performed in 79 aneurysms. Rates of recanalization and progressive thrombosis (total occlusion of the residual aneurysm at follow up) were 11{\%} and 38{\%}, respectively, in sidewall aneurysms, and 26{\%} and 0{\%}, respectively, in terminal aneurysms. Treatment with GDCs was effective for patients with small aneurysms with small necks, the morbidity was acceptable, and progressive thrombosis occurred during the follow-up period. GDC treatment achieved unsatisfactory results in patients with small terminal aneurysms with wide necks and in large aneurysms, because the obliteration rate was low, and the recanalization and complication rates were high. Multivariate analysis showed that complete occlusion was associated with small-necked aneurysms, and ischemic events tended to occur in terminal aneurysms and in aneurysms treated by the balloon-assisted technique.",
author = "Akio Soeda and Nobuyuki Sakai and Hideki Sakai and Koji Iihara and Izumi Nagata",
year = "2004",
month = "9",
day = "1",
doi = "10.2176/nmc.44.456",
language = "English",
volume = "44",
pages = "456--465",
journal = "Neurologia Medico-Chirurgica",
issn = "0470-8105",
publisher = "Japan Neurosurgical Society",
number = "9",

}

TY - JOUR

T1 - Endovascular treatment of asymptomatic cerebral aneurysms

T2 - Anatomic and technical factors related to ischemic events and coil stabilization

AU - Soeda, Akio

AU - Sakai, Nobuyuki

AU - Sakai, Hideki

AU - Iihara, Koji

AU - Nagata, Izumi

PY - 2004/9/1

Y1 - 2004/9/1

N2 - The present study assessed the safety and efficacy of embolization using Guglielmi detachable coils (GDCs) in 100 asymptomatic cerebral aneurysms classified as sidewall (70) or terminal (30) aneurysms according to the parent artery (68 small aneurysms with a small neck, 21 small aneurysms with a wide neck, and 11 large aneurysms). A balloon-assisted technique was used in 49 aneurysms. Immediate angiography revealed that 71 aneurysms were completely obliterated. Transient deficits occurred in 19 patients, permanent deficits in four patients, and one patient died. Most complications occurred during or immediately after treatment and resolved within a few minutes to a few weeks. None of the surviving patients manifested significant morbidity at 1-year follow up. Follow-up angiographic study was performed in 79 aneurysms. Rates of recanalization and progressive thrombosis (total occlusion of the residual aneurysm at follow up) were 11% and 38%, respectively, in sidewall aneurysms, and 26% and 0%, respectively, in terminal aneurysms. Treatment with GDCs was effective for patients with small aneurysms with small necks, the morbidity was acceptable, and progressive thrombosis occurred during the follow-up period. GDC treatment achieved unsatisfactory results in patients with small terminal aneurysms with wide necks and in large aneurysms, because the obliteration rate was low, and the recanalization and complication rates were high. Multivariate analysis showed that complete occlusion was associated with small-necked aneurysms, and ischemic events tended to occur in terminal aneurysms and in aneurysms treated by the balloon-assisted technique.

AB - The present study assessed the safety and efficacy of embolization using Guglielmi detachable coils (GDCs) in 100 asymptomatic cerebral aneurysms classified as sidewall (70) or terminal (30) aneurysms according to the parent artery (68 small aneurysms with a small neck, 21 small aneurysms with a wide neck, and 11 large aneurysms). A balloon-assisted technique was used in 49 aneurysms. Immediate angiography revealed that 71 aneurysms were completely obliterated. Transient deficits occurred in 19 patients, permanent deficits in four patients, and one patient died. Most complications occurred during or immediately after treatment and resolved within a few minutes to a few weeks. None of the surviving patients manifested significant morbidity at 1-year follow up. Follow-up angiographic study was performed in 79 aneurysms. Rates of recanalization and progressive thrombosis (total occlusion of the residual aneurysm at follow up) were 11% and 38%, respectively, in sidewall aneurysms, and 26% and 0%, respectively, in terminal aneurysms. Treatment with GDCs was effective for patients with small aneurysms with small necks, the morbidity was acceptable, and progressive thrombosis occurred during the follow-up period. GDC treatment achieved unsatisfactory results in patients with small terminal aneurysms with wide necks and in large aneurysms, because the obliteration rate was low, and the recanalization and complication rates were high. Multivariate analysis showed that complete occlusion was associated with small-necked aneurysms, and ischemic events tended to occur in terminal aneurysms and in aneurysms treated by the balloon-assisted technique.

UR - http://www.scopus.com/inward/record.url?scp=4744359037&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=4744359037&partnerID=8YFLogxK

U2 - 10.2176/nmc.44.456

DO - 10.2176/nmc.44.456

M3 - Article

C2 - 15600280

AN - SCOPUS:4744359037

VL - 44

SP - 456

EP - 465

JO - Neurologia Medico-Chirurgica

JF - Neurologia Medico-Chirurgica

SN - 0470-8105

IS - 9

ER -