Abstract
Multiple technologies have developed the endovascular approach to MCA aneurysms. We assess the safety and the efficacy of a systematic endovascular approach in nonselected patients with MCA aneurysms and determine predictors of treatment outcomes. We analyzed data collected between January 2007 and January 2012 in a prospective clinical registry. All patients with MCA aneurysms treated by means of the endovascular approach were included. A multivariate analysis was conducted to identify predictors of complications, recanalization, and outcome. A total of 120 patients with 131 MCA aneurysms were included. Seventy-nine patients (65.8%) were treated electively and 41 (34.2%) in the setting of subarachnoid hemorrhage. Thirty-three of 131 aneurysms (25.2%) were treated with simple coiling, 79 aneurysms (60.3%) with balloon-assisted coiling, and 19 aneurysms (14.5%) with stent-assisted coiling. Complications occurred in 13.7% of patients. Stent-assisted coiling was significantly associated with more complications (P = .002; OR: 4.86; 95% CI, 1.60-14.72). At 1 month after treatment, both the permanent morbidity (mRS ≤2) and mortality rates were 3.3%, without any significant difference according to the endovascular techniques. Mean angiographic follow-up was 16.3 months. The rate of recanalization was 15.6% without a statistical difference, according to the technique. Larger aneurysms were a predictor of recanalization (P = .016; OR: 1.183; 95% CI, 1.02-1.36). Retreatment was performed in 10 of 131 aneurysms (7.6%). Even though stent-assisted coiling significantly increases the risk of procedural complications, endovascular treatment of MCA aneurysms is safe, effective, and provides durable aneurysm closure in nonselected patients.
Highlights
BACKGROUND AND PURPOSEMultiple technologies have developed the endovascular approach to MCA aneurysms
Larger aneurysms were a predictor of recanalization (P ϭ .016; OR: 1.183; 95% CI, 1.02–1.36)
Initial Hunt and Hess (HH) grade of I was noted in 11 patients, HH grade of II in 10 patients, HH grade of III in 9 patients, HH grade of IV in 6 patients, and HH grade of V in 5 patients
Summary
We analyzed data collected between January 2007 and January 2012 in a prospective clinical registry. All patients with MCA aneurysms treated by means of the endovascular approach were included. A multivariate analysis was conducted to identify predictors of complications, recanalization, and outcome. Patients Patients were identified by means of a prospective clinical registry of patients with intracranial aneurysms, which were treated at Dupuytren University Hospital, Limoges, France, from January 2007 to January 2012. Since January 2007, a systematic endovascular approach has been implemented in all patients with MCA aneurysms. Fusiform and dissecting aneurysms were excluded, as were aneurysms associated with brain arteriovenous malformations. AJNR Am J Neuroradiol 35:715–20 Apr 2014 www.ajnr.org 715
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: 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.