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Coil embolization of unruptured middle cerebral artery aneurysms.

Authors
 Byung Moon Kim  ;  Dong Ik Kim  ;  Sung Il Park  ;  Dong Joon Kim  ;  Sang Hyun Suh  ;  Yu Sam Won 
Citation
 NEUROSURGERY, Vol.68(2) : 346-353, 2011 
Journal Title
NEUROSURGERY
ISSN
 0148-396X 
Issue Date
2011
MeSH
Adult ; Aged ; Cerebral Angiography ; Embolization, Therapeutic/methods* ; Female ; Humans ; Intracranial Aneurysm/diagnostic imaging* ; Intracranial Aneurysm/therapy* ; Male ; Middle Aged ; Retrospective Studies
Keywords
Intracranial aneurysm ; Coil embolization ; Middle cerebral artery ; Unruptured aneurysm
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.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006123-201102000-00017&LSLINK=80&D=ovft
DOI
10.1227/NEU.0b013e3182035fdc
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
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/22282913/93298
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