Back to Search
Start Over
Endovascular treatment of 346 middle cerebral artery aneurysms: results of a 16-year single-center experience
- Source :
- Neurosurgery. 76(1)
- Publication Year :
- 2014
-
Abstract
- BACKGROUND The endovascular treatment of middle cerebral artery (MCA) aneurysms has been controversial because of the frequency of complex anatomy and the relative ease of surgical clipping in this location. OBJECTIVE To present a large single-center experience with the endovascular treatment of MCA aneurysms. METHODS The neurointerventional database at our institution was reviewed for all endovascular treatments of MCA aneurysms. Demographics, aneurysm characteristics, treatment modality, intraprocedural hemorrhagic and thromboembolic events, 30-day neurological events, and follow-up angiographic studies were recorded. RESULTS From December 1996 to April 2013, 292 patients underwent endovascular treatment of 346 MCA aneurysms. Of these, 341 (98.6%) were successfully completed. Balloon neck remodeling was used in 230 procedures (66.5%). Ninety-five procedures (27.4%) were for ruptured aneurysms. The rate of intraprocedural hemorrhage was 2.6% (9 of 346). The overall rate of intraprocedural thromboembolic events was 13.6% (47 of 346), significantly more common in patients with acute subarachnoid hemorrhage (27.4%; P 2) neurological event rate was 2.9% (10 of 346), significantly more common in patients with subarachnoid hemorrhage (8.4%) compared with those without (0.8%; P < .001). The rate of complete or near-complete aneurysm occlusion at was 90.6% ≥ 6 months and 91.8% at ≥ 2 years, with an average of 24 months of follow-up available for 247 procedures. CONCLUSION Endovascular treatment of MCA aneurysms can be safe and effective. However, it is associated with a high asymptomatic thromboembolic event rate that is more frequent in the setting of acute subarachnoid hemorrhage.
- Subjects :
- Male
medicine.medical_specialty
Subarachnoid hemorrhage
medicine.medical_treatment
Aneurysm, Ruptured
Balloon
Single Center
Asymptomatic
Aneurysm
medicine.artery
Thromboembolism
Occlusion
Medicine
Humans
cardiovascular diseases
Embolization
Retrospective Studies
business.industry
Endovascular Procedures
Intracranial Aneurysm
Middle Aged
Subarachnoid Hemorrhage
medicine.disease
Embolization, Therapeutic
Surgery
Treatment Outcome
Middle cerebral artery
cardiovascular system
Female
Stents
Neurology (clinical)
Radiology
medicine.symptom
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 15244040
- Volume :
- 76
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Neurosurgery
- Accession number :
- edsair.doi.dedup.....0fe882a7b15bbcf9a662235ab4ec40bb