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Dual microcatheter coil embolization of acutely ruptured wide-necked intracranial aneurysms.
- Source :
- Interventional Neuroradiology; Oct2017, Vol. 23 Issue 5, p477-484, 8p
- Publication Year :
- 2017
-
Abstract
- The dual microcatheter technique is an alternative treatment for stent-assisted coiling in acutely ruptured wide-necked aneurysms because of no antiplatelet therapy. We assessed the safety and efficacy of this technique in ruptured wide-necked aneurysms. Between March 2008 and March 2016, 56 acutely ruptured aneurysms were treated with the dual microcatheter technique. The angiographic results, treatment-related complications, and clinical outcome were documented. Angiographic follow-up was available in 37 patients at a mean of 20.6 months (6 to 81 months). On the postembolization angiograms, 27 (48.2%) aneurysms showed complete occlusion (Raymond 1), 15 (26.8%) showed neck remnant (Raymond 2), and 14 (25.0%) showed body remnant (Raymond 3). Treatment-related complications occurred in seven patients (12.5%) and six patients remained asymptomatic. The permanent complication rate was 1.8% (1/56). A good outcome (modified Rankin Scale (mRS) score, 0-2) was observed in 64.3% of patients at the time of discharge. Five patients had died, all of the sequelae of subarachnoid hemorrhage. The overall mortality rate was 8.9% (5/56); however, the treatment-related mortality rate was 0%. Of the 37 aneurysms for which angiographic follow-up was available, 21 (56.8%) aneurysms demonstrated recanalization. Five aneurysms with recanalization were retreated endovascularly. There was one aneurysm re-rupture on follow-up and it rebled 21 months after the initial procedure. The dual microcatheter technique is a safe and effective treatment for acutely ruptured wide-necked aneurysms due to low treatment-related complication and mortality rate. However, the high rate of postembolization incomplete occlusion and recanalization remains as the main challenge. [ABSTRACT FROM AUTHOR]
- Subjects :
- ANEURYSMS
ANGIOGRAPHY
NEURORADIOLOGY
NEUROLOGICAL disorders
MEDICAL radiography
Subjects
Details
- Language :
- English
- ISSN :
- 15910199
- Volume :
- 23
- Issue :
- 5
- Database :
- Complementary Index
- Journal :
- Interventional Neuroradiology
- Publication Type :
- Academic Journal
- Accession number :
- 125444492
- Full Text :
- https://doi.org/10.1177/1591019917708570