The Relationship between Neck Size of the Cerebral Saccular Aneurysms and Outcome after Endovascular Intervention

Abstract

AbstractBackground: Intracranial aneurysms are common with a prevalence of 0.2% to 9% in adults. Intracranial aneurysms have high mortality and morbidity, so exclusion of aneurysms from cerebral circulation is aimed with established endovas-cular embolization.Aim of Study: Is to report our experience in managing intracranial aneurysms using coil embolization and to report the relation between neck size of cerebral aneurysms, its relation to dome height which is defined as Aspect Ratio (AR), and clinical, angiographic outcome after endovascular intervention.Patients and Methods: From July 2015 to May 2017, a series of 40 nonrandomized consecutive patients (mean age: 44.2±14.9 years) with 42 intracranial aneurysms underwent endovascular coil embolization in our center. We excluded patients with H & H grade 5 on admission and patients withH & H grade 4 were managed conservatively until improve-ment with better HH class I was achieved in 22 (68.8%) aneurysms, class II in 8 (25%) aneu-rysms, class IIIa in one (3.1%) aneurysm, class IIIb in one (3.1%) aneurysm. The wide necked group and AR 1.5, but in aneurysms with wide neck and AR <1.5, it is beneficial when assisted with additional forms of endovascular intervention (balloon, stent or flow diverters) for better treatment and improving outcome of the cases. Low aspect ratio plays a more dominant role than neck diameter in predicting the need for adjunctive techniques in the coiling of intracranial aneurysms.