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Coil embolization of unruptured middle cerebral artery aneurysms.

Authors
 Byung Moon Kim ; Dong Ik Kim ; Yu Sam Won ; Sang Hyun Suh ; Dong Joon Kim ; Sung Il Park 
Citation
 Neurosurgery, Vol.68(2) : 346~353, 2011 
Journal Title
 Neurosurgery 
ISSN
 0148-396X 
Issue Date
2011
Abstract
BACKGROUND: Since the International Subarachnoid Aneurysmal Trial, endovascular coiling has been increasingly used as primary treatment option for ruptured or unruptured aneurysms that are feasible for coiling. OBJECTIVE: To evaluate the feasibility and clinical and angiographic outcomes of coiling for unruptured middle cerebral artery aneurysms. METHODS: The records of 70 consecutive patients with 76 unruptured middle cerebral artery aneurysms who underwent coiling were retrospectively evaluated. RESULTS: Thirty-one aneurysms were treated by single-catheter, 18 by multicatheter, 11 by balloon-assisted, 13 by stent-assisted, and 3 by a combination of multicatheter and balloon-assisted techniques. Coiling was accomplished in 75 but failed in 1 aneurysm. One patient died of consequences of subarachnoid hemorrhage occurring 9 hours after coiling. One intraprocedural aneurysm rupture occurred, which was controlled by further coil insertions and left no sequelae. There were 1 cortical infarction and 1 basal ganglia infarction, both of which recovered completely. Treatment-related permanent morbidity and mortality rates were 0% and 1.4%, respectively. Postembolization control angiography revealed 40 complete, 30 neck remnant, and 5 incomplete occlusions. Clinical follow-up was available in all patients (mean, 25 months; range, 7-105 months). There was no subarachnoid hemorrhage during follow-up, but 1 death resulting from acute myocardial infarction occurred 3 months after coiling. None of the surviving patients had any neurological deterioration. Follow-up angiography was available in 69 aneurysms at 6 to 24 months (mean, 12 months). Three major and 6 minor recurrences were detected. All 3 major recurrent aneurysms were re-treated by coiling without any complications. CONCLUSION: Most unruptured middle cerebral artery aneurysms could be safely treated by coiling with acceptable short-term to midterm outcomes. Our results warrant further study with a longer follow-up period in a larger population.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/93298
DOI
10.1227/NEU.0b013e3182035fdc
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Radiology
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Link
 http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006123-201102000-00017&LSLINK=80&D=ovft
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