Abstract
Purpose.Endovascular parent artery occlusion (PAO) may be an alternative approach for complex intracranial aneurysm with potentially life-threatening complications. Moreover, the long-term follow-up of the PAO for an intracranial aneurysm is reported sparingly, limited to the case series. It is therefore important to carry out more research on long-term follow-up of the implication of PAO of intracranial aneurysm. The aim of the study was to analyses our experience of PAO for intracranial aneurysms with emphasis on long-term follow-up. Materials and Methods.The data of patients treated with PAO for intracranial aneurysms were reviewed. The outcome was evaluated based on aneurysmal occlusion on immediate angiography, follow-up magnetic resonance angiography (MRA), and complications. The modified Rankin score (mRS) was used to evaluate the functional outcome during the last follow-up. The mean, range, and standard deviation were reported for other variables – the patient’s age, number, and percentage. Results.Endovascular treatment was performed in 178 patients including PAO in 18 patients. Of these 18 (eighteen) patients, there were 13 dissecting aneurysms, 4 mycotic aneurysms, and one traumatic aneurysm.10 (ten) patients underwent PAO for proximal intracranial artery aneurysm and 8 (eight) patients for distal cerebral aneurysms. Complete occlusion of the aneurysm was achieved in 16patients (88.89%) and retrograde filling of the aneurysm was seen in 2 (11.11%) patients. One patient had intraprocedural coil migration resulting in a major infarct with an mRS of 2. Another patient (5.56%) had recanalization of the aneurysm and presented with rupture and intracranial hemorrhage with an mRS score of 4. The mRS of the other 16 patients (88.89%) was zero. Conclusions.Endovascular PAO for cerebral aneurysms was highly feasible and achieved complete occlusion. The morbidity and mortality rates were at the long-term follow-up also acceptable with negligible complications.
Highlights
Endovascular coiling is currently an incredible approach for intracranial aneurysms
Endovascular treatment was performed in 178 patients including parent artery occlusion (PAO) in 18 patients
The morbidity and mortality rates were at the long-term follow-up acceptable with negligible complications
Summary
Endovascular coiling is currently an incredible approach for intracranial aneurysms. Recent approaches like flow diversion make it feasible for complex aneurysms where simple or balloon-assisted coiling is not amenable [1,2]. Endovascular parent artery occlusion (PAO) may be an alternative approach in such situations [3, 4], which has been practiced long in the tooth despite the potentially life-threatening complications like delayed ischemia or hemorrhage and de-novo aneurysm formation. The long-term follow-up of the PAO for the intracranial aneurysm is Pranjal Phukan et al Endovascular Parent Artery Occlusion for Intracranial Aneurysms is a Viable, Cost-Effective Alternative: reported sparingly limited to the case series. It is important to carry out more research on long-term follow-up of the implication of PAO of intracranial aneurysm. The study aimed to analyze our experience of PAO for intracranial aneurysms with an emphasis on long-term follow-up
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