Abstract
Our purpose was to evaluate the effectiveness of endovascular therapy using detachable coils and balloons for the direct occlusion of intracranial aneurysms. We retrospectively reviewed 563 patients undergoing digital subtraction angiography from January 2007 to July 2009. Two hundred and fifty patients with 323 embolized intracranial aneurysms were studied. Among 250 patients, 66 % were female and 34 % male, the age ranging from 19 - 83 years (mean 50.66 ± 12.92). One hundred and seventy-seven had a single aneurysm while 73 showed multiple aneurysms. Seventeen (9.6 %) had giant aneurysms. Three hundred and eleven aneurysms were treated using detachable coils, and 12 giant aneurysms were embolized by detachable balloons for the parent vessel occlusion. Of 323 aneurysms treated via the endovascular approach, total occlusion was seen in 93 % of the aneurysms, near total occlusion in 5.2 % and incomplete embolization in 1.5 %. Among patients presenting with sub-arachnoid hemorrhage, 62 improved to the Glasgow outcome score (GOS) of 5, 93 improved to GOS 4, 14 improved to GOS 3, 10 improved to GOS 2 at the time of discharge and 5 patients died. Angiographic follow-up was scheduled between 6 - 12 months post-embolization. The aneurysm recurred in 1.2 % and were re-embolized using additional coils. Statistically, Hunt and Hess Grade and GOS indicated clinical significance (P < 0.05). The patients, gender, clinical presentation and aneurysmal location did not show statistical significance (P > 0.05). Hunt and Hess VI and V are considered as poor clinical gradings in aneurysmal SAH. However, endovascular treatment has been established as an effective method to obliterate intracranial aneurysms allowing subsequent decrease in mortality and morbidity.
Highlights
Our purpose was to evaluate the effectiveness of endovascular therapy using detachable coils and balloons for the direct occlusion of intracranial aneurysms
Our search yielded 250 patients with 323 intracranial aneurysms among 563 Digital subtraction angiogram (DSA), who had been subsequently treated by endovascular therapy using detachable coils and balloons
Among 323 aneurysms, 311 had been embolized using Guglielmi detachable coils (GDCs) and 12 giant aneurysm of internal carotid artery (ICA) with presence of good collateral flow had been with detachable balloons
Summary
Our purpose was to evaluate the effectiveness of endovascular therapy using detachable coils and balloons for the direct occlusion of intracranial aneurysms. Endovascular therapy has been an increasingly used method for the obliteration of intracranial aneurysms since the early 1970s when Fedor A. Serbinenko succeeded in experimenting with latex balloons and Guido Guglielmi perfected the technique of coil embolization in 1991.1,2 With the successful results achieved in shortterm clinical and angiographic follow-ups, this technique has proven to be an alternative therapy to surgical clipping.[2,3] Due to the complex anatomical structures, perforating vessels and cranial nerves, surgical access to those aneurysms located in difficult locations are Correspondence: JNMA I VOL 51 I NO. Tamrakar et al Efficacy of endovascular therapy for direct occlusion of Intracranial Aneurysms difficult to trap and clip, carrying a high risk of damage to surrounding brain parenchyma. The new advancement made in the materials and methods used in interventionals neurosurgery have further refined the endovascular technology for a more successful treatment of intracranial aneurysms
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
