Abstract
BackgroundEndovascular management for cerebral saccular aneurysm has evolved in the last decade with evolution in both equipment and material. Coiling is still the mainstay of cerebral aneurysm endovascular management. In Egypt, practice outcome needs evaluation especially at low-volume centers.PurposeTo discuss the technical and management outcomes of our first symptomatic and asymptomatic cerebral saccular aneurysm case series treated with simple coiling.Patients and methodsClinical, treatment, and outcome variables of consecutive symptomatic and asymptomatic cerebral aneurysm cases treated with simple coiling between January 2011 and June 2016 in one center were analyzed.ResultsIn 31 patients, 35 aneurysms were found, 34 aneurysms (97.1%) were treated by endovascular coiling, and only one aneurysm (2.9%) was not fit for endovascular treatment. Total occlusion was achieved in 29 aneurysms (82.9%). Neck remnants were present in 4 aneurysms (11.4%). Partial coiling (incomplete occlusion) was achieved in 1 aneurysm (2.9%). Regarding functional outcome (mRS at discharge), 25 patients had good outcome (mRS = 0, 1, 2, 3) and 6 patients had poor outcome (mRS = 4, 5, 6).ConclusionThe endovascular coiling could be used as a first-choice option for treatment of saccular cerebral aneurysms at our center despite the low case rate.
Highlights
After the International Subarachnoid Aneurysm Trial (ISAT) [1], endovascular coiling became the first treatment option in many countries
The endovascular coiling could be used as a first-choice option for treatment of saccular cerebral aneurysms at our center despite the low case rate
A “good” outcome was defined as a Modified Rankin Scale (mRS) score of 0–2 at discharge; a “poor” outcome was defined as a mRS score of 3–6 at discharge
Summary
After the International Subarachnoid Aneurysm Trial (ISAT) [1], endovascular coiling became the first treatment option in many countries. The ISAT trial showed that coiling was associated with 7.4% absolute risk reduction at the outset and significantly fewer dead and dependent patients at 1 year than did clipping. After 10 years follow-up, the rates of increased dependency did not differ between both groups, the probability of death or dependency was significantly greater in the clipping group than in the coiling group. The rate of poor outcome after 1 year was significantly lower in patients who underwent endovascular coiling in two recent. Coiling is still the mainstay of cerebral aneurysm endovascular management. Purpose: To discuss the technical and management outcomes of our first symptomatic and asymptomatic cerebral saccular aneurysm case series treated with simple coiling
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