Thromboembolic Events Associated with Guglielmi Detachable Coil Embolization with Use of Diffusion-Weighted MR Imaging. Part II. Detection of the Microemboli Proximal to Cerebral Aneurysm

Akio Soeda, Nobuyuki Sakai, Kenichi Murao, Hideki Sakai, Koji Iihara, Naoaki Yamada, Satoshi Imakita, Izumi Nagata

研究成果: ジャーナルへの寄稿記事

61 引用 (Scopus)

抄録

BACKGROUND AND PURPOSE: The purpose of this study was to document the incidence and radiologic appearance of thromboembolic events during Guglielmi detachable coil (GDC) embolization for asymptomatic basilar artery (BA) bifurcation and BA-superior cerebellar artery (SCA) aneurysms by using diffusion-weighted (DW) MR imaging, with special emphasis on the evidence of thromboembolic events in vascular territories proximal from the treated aneurysm, which cause cerebellar infarction, and to discuss which step of the procedure (aneurysm or catheter manipulation) may play a role for most thromboembolic events. METHODS: Since 1999, 38 asymptomatic BA bifurcation and BA-SCA aneurysms were treated with GDCs at the National Cardiovascular Center. DW studies were performed for 26 patients between 2 and 5 days after GDC embolizations. All DW images were reviewed by two radiologists for depiction of abnormalities. These findings were retrospectively evaluated with clinical and technical factors of thromboembolic events. RESULTS: DW images showed new hyperintense lesions in 18 patients (69%), with seven (27%) incurring neurologic deteriorations. All symptomatic patients fully recovered by discharge. Fourteen (78%) of 18 patients showed new lesions proximal to the treated aneurysm; that is, in the cerebellar hemispheres. In three cases treated with the balloon-assisted technique, new hyperintense lesions were seen. CONCLUSION: In our experience, most thromboembolic events related to the use of the GDC embolization may be caused by catheter manipulation, especially in the case of the balloon-assisted technique. Caution should be exercised in the handling of catheters. Furthermore, a softer and smaller caliber catheter and simple GDC technique should be considered.

元の言語英語
ページ(範囲)2035-2038
ページ数4
ジャーナルAmerican Journal of Neuroradiology
24
発行部数10
出版物ステータス出版済み - 11 1 2003
外部発表Yes

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Intracranial Aneurysm
Basilar Artery
Aneurysm
Catheters
Arteries
Infarction
Nervous System
Blood Vessels
Incidence

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Clinical Neurology

これを引用

Thromboembolic Events Associated with Guglielmi Detachable Coil Embolization with Use of Diffusion-Weighted MR Imaging. Part II. Detection of the Microemboli Proximal to Cerebral Aneurysm. / Soeda, Akio; Sakai, Nobuyuki; Murao, Kenichi; Sakai, Hideki; Iihara, Koji; Yamada, Naoaki; Imakita, Satoshi; Nagata, Izumi.

:: American Journal of Neuroradiology, 巻 24, 番号 10, 01.11.2003, p. 2035-2038.

研究成果: ジャーナルへの寄稿記事

Soeda, Akio ; Sakai, Nobuyuki ; Murao, Kenichi ; Sakai, Hideki ; Iihara, Koji ; Yamada, Naoaki ; Imakita, Satoshi ; Nagata, Izumi. / Thromboembolic Events Associated with Guglielmi Detachable Coil Embolization with Use of Diffusion-Weighted MR Imaging. Part II. Detection of the Microemboli Proximal to Cerebral Aneurysm. :: American Journal of Neuroradiology. 2003 ; 巻 24, 番号 10. pp. 2035-2038.
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abstract = "BACKGROUND AND PURPOSE: The purpose of this study was to document the incidence and radiologic appearance of thromboembolic events during Guglielmi detachable coil (GDC) embolization for asymptomatic basilar artery (BA) bifurcation and BA-superior cerebellar artery (SCA) aneurysms by using diffusion-weighted (DW) MR imaging, with special emphasis on the evidence of thromboembolic events in vascular territories proximal from the treated aneurysm, which cause cerebellar infarction, and to discuss which step of the procedure (aneurysm or catheter manipulation) may play a role for most thromboembolic events. METHODS: Since 1999, 38 asymptomatic BA bifurcation and BA-SCA aneurysms were treated with GDCs at the National Cardiovascular Center. DW studies were performed for 26 patients between 2 and 5 days after GDC embolizations. All DW images were reviewed by two radiologists for depiction of abnormalities. These findings were retrospectively evaluated with clinical and technical factors of thromboembolic events. RESULTS: DW images showed new hyperintense lesions in 18 patients (69{\%}), with seven (27{\%}) incurring neurologic deteriorations. All symptomatic patients fully recovered by discharge. Fourteen (78{\%}) of 18 patients showed new lesions proximal to the treated aneurysm; that is, in the cerebellar hemispheres. In three cases treated with the balloon-assisted technique, new hyperintense lesions were seen. CONCLUSION: In our experience, most thromboembolic events related to the use of the GDC embolization may be caused by catheter manipulation, especially in the case of the balloon-assisted technique. Caution should be exercised in the handling of catheters. Furthermore, a softer and smaller caliber catheter and simple GDC technique should be considered.",
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T1 - Thromboembolic Events Associated with Guglielmi Detachable Coil Embolization with Use of Diffusion-Weighted MR Imaging. Part II. Detection of the Microemboli Proximal to Cerebral Aneurysm

AU - Soeda, Akio

AU - Sakai, Nobuyuki

AU - Murao, Kenichi

AU - Sakai, Hideki

AU - Iihara, Koji

AU - Yamada, Naoaki

AU - Imakita, Satoshi

AU - Nagata, Izumi

PY - 2003/11/1

Y1 - 2003/11/1

N2 - BACKGROUND AND PURPOSE: The purpose of this study was to document the incidence and radiologic appearance of thromboembolic events during Guglielmi detachable coil (GDC) embolization for asymptomatic basilar artery (BA) bifurcation and BA-superior cerebellar artery (SCA) aneurysms by using diffusion-weighted (DW) MR imaging, with special emphasis on the evidence of thromboembolic events in vascular territories proximal from the treated aneurysm, which cause cerebellar infarction, and to discuss which step of the procedure (aneurysm or catheter manipulation) may play a role for most thromboembolic events. METHODS: Since 1999, 38 asymptomatic BA bifurcation and BA-SCA aneurysms were treated with GDCs at the National Cardiovascular Center. DW studies were performed for 26 patients between 2 and 5 days after GDC embolizations. All DW images were reviewed by two radiologists for depiction of abnormalities. These findings were retrospectively evaluated with clinical and technical factors of thromboembolic events. RESULTS: DW images showed new hyperintense lesions in 18 patients (69%), with seven (27%) incurring neurologic deteriorations. All symptomatic patients fully recovered by discharge. Fourteen (78%) of 18 patients showed new lesions proximal to the treated aneurysm; that is, in the cerebellar hemispheres. In three cases treated with the balloon-assisted technique, new hyperintense lesions were seen. CONCLUSION: In our experience, most thromboembolic events related to the use of the GDC embolization may be caused by catheter manipulation, especially in the case of the balloon-assisted technique. Caution should be exercised in the handling of catheters. Furthermore, a softer and smaller caliber catheter and simple GDC technique should be considered.

AB - BACKGROUND AND PURPOSE: The purpose of this study was to document the incidence and radiologic appearance of thromboembolic events during Guglielmi detachable coil (GDC) embolization for asymptomatic basilar artery (BA) bifurcation and BA-superior cerebellar artery (SCA) aneurysms by using diffusion-weighted (DW) MR imaging, with special emphasis on the evidence of thromboembolic events in vascular territories proximal from the treated aneurysm, which cause cerebellar infarction, and to discuss which step of the procedure (aneurysm or catheter manipulation) may play a role for most thromboembolic events. METHODS: Since 1999, 38 asymptomatic BA bifurcation and BA-SCA aneurysms were treated with GDCs at the National Cardiovascular Center. DW studies were performed for 26 patients between 2 and 5 days after GDC embolizations. All DW images were reviewed by two radiologists for depiction of abnormalities. These findings were retrospectively evaluated with clinical and technical factors of thromboembolic events. RESULTS: DW images showed new hyperintense lesions in 18 patients (69%), with seven (27%) incurring neurologic deteriorations. All symptomatic patients fully recovered by discharge. Fourteen (78%) of 18 patients showed new lesions proximal to the treated aneurysm; that is, in the cerebellar hemispheres. In three cases treated with the balloon-assisted technique, new hyperintense lesions were seen. CONCLUSION: In our experience, most thromboembolic events related to the use of the GDC embolization may be caused by catheter manipulation, especially in the case of the balloon-assisted technique. Caution should be exercised in the handling of catheters. Furthermore, a softer and smaller caliber catheter and simple GDC technique should be considered.

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