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Endovascular treatment of 300 consecutive middle cerebral artery aneurysms: clinical and radiologic outcomes.
- Source :
-
AJNR. American journal of neuroradiology [AJNR Am J Neuroradiol] 2014 Apr; Vol. 35 (4), pp. 706-14. Date of Electronic Publication: 2013 Nov 14. - Publication Year :
- 2014
-
Abstract
- Background and Purpose: There is controversy as to the best mode of treating MCA aneurysms. We report the results of a large endovascular series of patients treated at our center.<br />Materials and Methods: This study was a retrospective analysis of a prospectively acquired data base. All patients with saccular MCA aneurysms treated between November 1996 and June 2012 were included. World Federation of Neurosurgical Societies grade, aneurysm site, size, and aneurysm neck size were recorded, along with clinical outcome assessed with the Glasgow Outcome Scale and radiographic occlusion assessed with the Raymond classification at 6 months and 2.5 years.<br />Results: A total of 295 patients with 300 MCA aneurysms were treated including 244 ruptured aneurysms (80.7%). The technical failure rate was 4.3% (13 patients). Complete occlusion or neck remnant was achieved in 264 (91.4%). Complications included rupture in 15 patients (5%), thromboembolism in 17 patients (5.7%), and early rebleeding in 3 patients (1%). Overall permanent procedural-related morbidity and mortality were seen in 12 patients (7.8%). Of the ruptured aneurysms, 189 (79.4%) had a favorable clinical outcome (Glasgow Outcome Scale score, 4-5). A total of 33 patients (13.6%) died. On initial angiographic follow-up, aneurysm remnant was seen in 18 aneurysms (8.1%). A total of 13 patients (4.3%) were re-treated.<br />Conclusions: Our experience demonstrates that endovascular treatment of MCA aneurysms has an acceptable safety profile with low rates of technical failure and re-treatment. Therefore, coiling is acceptable as the primary treatment of MCA aneurysms.
- Subjects :
- Adult
Aged
Aged, 80 and over
Aneurysm, Ruptured diagnostic imaging
Aneurysm, Ruptured mortality
Cerebral Angiography
Female
Follow-Up Studies
Humans
Infarction, Middle Cerebral Artery diagnostic imaging
Infarction, Middle Cerebral Artery mortality
Intracranial Aneurysm diagnostic imaging
Intracranial Aneurysm mortality
Intracranial Aneurysm surgery
Intracranial Thrombosis diagnostic imaging
Intracranial Thrombosis mortality
Male
Middle Aged
Prospective Studies
Retrospective Studies
Treatment Outcome
Young Adult
Aneurysm, Ruptured etiology
Endovascular Procedures adverse effects
Endovascular Procedures methods
Infarction, Middle Cerebral Artery surgery
Intracranial Thrombosis etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1936-959X
- Volume :
- 35
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- AJNR. American journal of neuroradiology
- Publication Type :
- Academic Journal
- Accession number :
- 24231847
- Full Text :
- https://doi.org/10.3174/ajnr.A3776