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Endovascular coil embolization of aneurysms with a branch incorporated into the sac

Authors
 B.M. Kim  ;  S.I. Park  ;  D.J. Kim  ;  D.I. Kim  ;  S.H. Suh  ;  T.H. Kwon  ;  H.S. Choi  ;  Y.S. Won 
Citation
 AMERICAN JOURNAL OF NEURORADIOLOGY, Vol.31(1) : 145-151, 2010 
Journal Title
 AMERICAN JOURNAL OF NEURORADIOLOGY 
ISSN
 0195-6108 
Issue Date
2010
MeSH
Adult ; Aged ; Aged, 80 and over ; Embolization, Therapeutic* ; Feasibility Studies ; Female ; Humans ; Intracranial Aneurysm/complications ; Intracranial Aneurysm/pathology ; Intracranial Aneurysm/therapy* ; Male ; Middle Aged ; Retrospective Studies
Abstract
BACKGROUND AND PURPOSE: Because of the concern for occlusion of the incorporated branch artery, an aneurysm with a branch incorporated into the sac has been regarded as a contraindication for coiling. The aim of this study is to evaluate the feasibility, techniques, and clinical and angiographic outcomes of coiling for aneurysms with a branch incorporated into the sac. MATERIALS AND METHODS: The medical records and radiologic studies of 69 patients with 79 aneurysms having a branch incorporated into the sac (26 ruptured, 53 unruptured) were retrospectively reviewed and evaluated. RESULTS: Coiling was accomplished in 78 aneurysms in 68 patients but was suspended in 1 due to incorporated branch occlusion. The aneurysms were treated by using the following techniques: single-catheter (n = 37), multicatheter (n = 22), balloon-remodeling (n = 7), stent-assisted coiling (n = 6), and combined (n = 7). Postembolization angiography revealed the following: near-complete occlusion in 71 (89.8%), remnant neck in 4 (5.1%), and incomplete occlusion in 4 (5.1%) aneurysms. Procedure-related permanent morbidity and mortality rates were 5.8% (4/69) and 0%, respectively. All patients with unruptured aneurysms had a modified Rankin Scale (mRS) score of 0, except for 1 patient who had an mRS score of 3. Of the 26 patients with ruptured aneurysms, 18 had favorable outcome (mRS 0-2) but 8 had poor outcome (mRS 3-6). Follow-up angiography was available at least once at 6-50 months (mean, 15 months) in 55 aneurysms (69.6%), of which 45 showed stable or improved occlusion; 4, minor recurrences; and 6, major recurrences. All 6 major recurrent aneurysms were retreated without complication by using a single-catheter (n = 1), multicatheter (n = 2), or balloon-assisted technique (n = 3). CONCLUSIONS: With appropriate techniques, most aneurysms with a branch incorporated into the sac could be safely treated by coiling, with acceptable outcomes.
Files in This Item:
T201000108.pdf Download
DOI
10.3174/ajnr.A1785
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Tae Hyung(권태형)
Kim, Dong Ik(김동익)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Byung Moon(김병문) ORCID logo https://orcid.org/0000-0001-8593-6841
Park, Sung Il(박성일)
Suh, Sang Hyun(서상현) ORCID logo https://orcid.org/0000-0002-7098-4901
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100475
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