Skip to main content
Advertisement
  • Main menu
  • User menu
  • Search
  • English ▼
    • English
    • Afrikaans
    • Albanian
    • Amharic
    • Arabic
    • Armenian
    • Azerbaijani
    • Basque
    • Belarusian
    • Bengali
    • Bosnian
    • Bulgarian
    • Catalan
    • Cebuano
    • Chichewa
    • Chinese (Simplified)
    • Chinese (Traditional)
    • Corsican
    • Croatian
    • Czech
    • Danish
    • Dutch
    • Esperanto
    • Estonian
    • Filipino
    • Finnish
    • French
    • Frisian
    • Galician
    • Georgian
    • German
    • Greek
    • Gujarati
    • Haitian Creole
    • Hausa
    • Hawaiian
    • Hebrew
    • Hindi
    • Hmong
    • Hungarian
    • Icelandic
    • Igbo
    • Indonesian
    • Irish
    • Italian
    • Japanese
    • Javanese
    • Kannada
    • Kazakh
    • Khmer
    • Korean
    • Kurdish (Kurmanji)
    • Kyrgyz
    • Lao
    • Latin
    • Latvian
    • Lithuanian
    • Luxembourgish
    • Macedonian
    • Malagasy
    • Malay
    • Malayalam
    • Maltese
    • Maori
    • Marathi
    • Mongolian
    • Myanmar (Burmese)
    • Nepali
    • Norwegian
    • Pashto
    • Persian
    • Polish
    • Portuguese
    • Punjabi
    • Romanian
    • Russian
    • Samoan
    • Scottish Gaelic
    • Serbian
    • Sesotho
    • Shona
    • Sindhi
    • Sinhala
    • Slovak
    • Slovenian
    • Somali
    • Spanish
    • Sudanese
    • Swahili
    • Swedish
    • Tajik
    • Tamil
    • Telugu
    • Thai
    • Turkish
    • Ukrainian
    • Urdu
    • Uzbek
    • Vietnamese
    • Welsh
    • Xhosa
    • Yiddish
    • Yoruba
    • Zulu

Main menu

  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • Advancing NeuroMRI with High-Relaxivity Contrast Agents
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home

User menu

  • Alerts
  • Log in

Search

  • Advanced search
American Journal of Neuroradiology
American Journal of Neuroradiology

American Journal of Neuroradiology

ASHNR American Society of Functional Neuroradiology ASHNR American Society of Pediatric Neuroradiology ASSR
  • Alerts
  • Log in

Advanced Search

English ▼
  • English
  • Afrikaans
  • Albanian
  • Amharic
  • Arabic
  • Armenian
  • Azerbaijani
  • Basque
  • Belarusian
  • Bengali
  • Bosnian
  • Bulgarian
  • Catalan
  • Cebuano
  • Chichewa
  • Chinese (Simplified)
  • Chinese (Traditional)
  • Corsican
  • Croatian
  • Czech
  • Danish
  • Dutch
  • Esperanto
  • Estonian
  • Filipino
  • Finnish
  • French
  • Frisian
  • Galician
  • Georgian
  • German
  • Greek
  • Gujarati
  • Haitian Creole
  • Hausa
  • Hawaiian
  • Hebrew
  • Hindi
  • Hmong
  • Hungarian
  • Icelandic
  • Igbo
  • Indonesian
  • Irish
  • Italian
  • Japanese
  • Javanese
  • Kannada
  • Kazakh
  • Khmer
  • Korean
  • Kurdish (Kurmanji)
  • Kyrgyz
  • Lao
  • Latin
  • Latvian
  • Lithuanian
  • Luxembourgish
  • Macedonian
  • Malagasy
  • Malay
  • Malayalam
  • Maltese
  • Maori
  • Marathi
  • Mongolian
  • Myanmar (Burmese)
  • Nepali
  • Norwegian
  • Pashto
  • Persian
  • Polish
  • Portuguese
  • Punjabi
  • Romanian
  • Russian
  • Samoan
  • Scottish Gaelic
  • Serbian
  • Sesotho
  • Shona
  • Sindhi
  • Sinhala
  • Slovak
  • Slovenian
  • Somali
  • Spanish
  • Sudanese
  • Swahili
  • Swedish
  • Tajik
  • Tamil
  • Telugu
  • Thai
  • Turkish
  • Ukrainian
  • Urdu
  • Uzbek
  • Vietnamese
  • Welsh
  • Xhosa
  • Yiddish
  • Yoruba
  • Zulu
  • Home
  • Content
    • Current Issue
    • Accepted Manuscripts
    • Article Preview
    • Past Issue Archive
    • Video Articles
    • AJNR Case Collection
    • Case of the Week Archive
    • Case of the Month Archive
    • Classic Case Archive
  • Special Collections
    • Advancing NeuroMRI with High-Relaxivity Contrast Agents
    • AJNR Awards
    • Low-Field MRI
    • Alzheimer Disease
    • ASNR Foundation Special Collection
    • Photon-Counting CT
    • View All
  • Multimedia
    • AJNR Podcasts
    • AJNR SCANtastic
    • Trainee Corner
    • MRI Safety Corner
    • Imaging Protocols
  • For Authors
    • Submit a Manuscript
    • Submit a Video Article
    • Submit an eLetter to the Editor/Response
    • Manuscript Submission Guidelines
    • Statistical Tips
    • Fast Publishing of Accepted Manuscripts
    • Graphical Abstract Preparation
    • Imaging Protocol Submission
    • Author Policies
  • About Us
    • About AJNR
    • Editorial Board
    • Editorial Board Alumni
  • More
    • Become a Reviewer/Academy of Reviewers
    • Subscribers
    • Permissions
    • Alerts
    • Feedback
    • Advertisers
    • ASNR Home
  • Follow AJNR on Twitter
  • Visit AJNR on Facebook
  • Follow AJNR on Instagram
  • Join AJNR on LinkedIn
  • RSS Feeds

AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates


Improved Turnaround Times | Median time to first decision: 12 days

Research ArticleNeurointervention

Difficult Aneurysms for Endovascular Treatment: Overwide or Undertall?

W. Brinjikji, H.J Cloft and D.F. Kallmes
American Journal of Neuroradiology September 2009, 30 (8) 1513-1517; DOI: https://doi.org/10.3174/ajnr.A1633
W. Brinjikji
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
H.J Cloft
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
D.F. Kallmes
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF
Loading

Article Figures & Data

Figures

  • Tables
  • Fig 1.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 1.

    Effect of dome-to-neck ratio on the need for adjunctive devices in endovascular management. This graph demonstrates the influence of dome-to-neck ratio on treatment decisions. For cases with dome-to-neck ratios <1.6, adjunctive techniques were used in most of them, whereas for cases with dome-to-neck ratios >1.6, aneurysms were treated without adjunctive techniques in most of them.

  • Fig 2.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 2.

    Effect of neck size on the need for adjunctive devices in endovascular management. This graph demonstrates the influence of neck size on treatment decisions. For a neck size <4.0 mm, coiling without adjunctive techniques was favored over coiling with adjunctive techniques. At a neck size >4.0 mm, this was no longer true.

  • Fig 3.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 3.

    Effect of aspect ratio on the need for adjunctive devices in endovascular management. This graph demonstrates the influence of aspect ratio on the need for adjunctive techniques. Most cases with aspect ratios <1.4 necessitated adjunctive techniques in their management; however, statistical significance was attained at an aspect ratio >1.6.

  • Fig 4.
    • Download figure
    • Open in new tab
    • Download powerpoint
    Fig 4.

    Coiling of middle cerebral artery aneurysm. Images show the successful coiling of a middle cerebral artery bifurcation aneurysm without adjunctive techniques in a 50-year-old man. A, This aneurysm has an unfavorable dome-to-neck ratio (1.3), an unfavorable neck width (5.0 mm), and a favorable aspect ratio (1.8). Given the low dome-to-neck ratio and large neck width, this aneurysm would have been considered not amenable to coiling without adjunctive techniques. B, Immediate postoperative image of the aneurysm shows near-complete coiling with a small neck remnant.

Tables

  • Figures
    • View popup
    Table 1:

    Characteristics of aneurysms treated with and without adjunctive techniques

    No.Average D/N (SD)Average Aspect Ratio (SD)Average Neck Size (mm) (SD)
    Coiled without adjunctive technique1151.97 (.59)2.09 (0.67)3.0 (1.5)
    Coiled with adjunctive technique701.59 (.42)1.48 (0.59)4.0 (2.0)
        Coiled + inflated balloon511.67 (0.45)1.57 (0.63)3.8 (1.7)
        Coiled + noninflated balloon51.5 (0.16)1.41 (0.34)3.9 (4.1)
        Coiled + stented111.33 (0.20)1.20 (0.35)4.9 (2.1)
        Coiled + stented + balloon31.36 (0.16)1.00 (0.08)4.7 (1.2)
    • Note:—D/N indicates dome-to-neck ratio.

    • View popup
    Table 2:

    Percentage of cases needing adjunctive techniques at given dome-to-neck and aspect ratios

    D/N
    <1.6>1.6
    AR<1.674%42%
    >1.623%20%
    • Note:—AR indicates aspect ratio.

PreviousNext
Back to top

In this issue

American Journal of Neuroradiology: 30 (8)
American Journal of Neuroradiology
Vol. 30, Issue 8
1 Sep 2009
  • Table of Contents
  • Index by author
Advertisement
Print
Download PDF
Email Article
Cite this article
0 Responses
Respond to this article
Share
Bookmark this article
Difficult Aneurysms for Endovascular Treatment: Overwide or Undertall?
W. Brinjikji, H.J Cloft, D.F. Kallmes
American Journal of Neuroradiology Sep 2009, 30 (8) 1513-1517; DOI: 10.3174/ajnr.A1633
del.icio.us logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
Purchase

Jump to section

  • Article
    • Abstract
    • Materials and Methods
    • Results
    • Discussion
    • Conclusions
    • References
  • Figures & Data
  • Info & Metrics
  • Responses
  • References
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Lateral Compression Manipulation: A Simple Approach for Sizing Taller-Than-Wide Intracranial Aneurysms with the Woven EndoBridge Device
  • Deep learning-based cerebral aneurysm segmentation and morphological analysis with three-dimensional rotational angiography
  • Deep learning-based cerebral aneurysm segmentation and morphological analysis with three-dimensional rotational angiography
  • Development of the SAFETEA Scores for Predicting Risks of Complications of Preventive Endovascular or Microneurosurgical Intracranial Aneurysm Occlusion
  • Endovascular Treatment of Small and Very Small Intracranial Aneurysms with the Woven EndoBridge Device
  • Flow-Diversion Treatment for Unruptured ICA Bifurcation Aneurysms with Unfavorable Morphology for Coiling
  • eCLIPs bifurcation remodeling system for treatment of wide neck bifurcation aneurysms with extremely low dome-to-neck and aspect ratios: a multicenter experience
  • Early clinical experience with Cascade: a novel temporary neck bridging device for embolization of intracranial aneurysms
  • Critical role of angiographic acquisition modality and reconstruction on morphometric and haemodynamic analysis of intracranial aneurysms
  • Safety and effectiveness of the Low Profile Visualized Intraluminal Support (LVIS and LVIS Jr) devices in the endovascular treatment of intracranial aneurysms: results of the TRAIL multicenter observational study
  • European Multicenter Study for the Evaluation of a Dual-Layer Flow-Diverting Stent for Treatment of Wide-Neck Intracranial Aneurysms: The European Flow-Redirection Intraluminal Device Study
  • WEB Treatment of Ruptured Intracranial Aneurysms: A Single-Center Cohort of 100 Patients
  • Coiling of wide-necked carotid artery aneurysms assisted by a temporary bridging device (Comaneci): preliminary experience
  • Single-center experience in the endovascular treatment of wide-necked intracranial aneurysms with a bridging intra-/extra-aneurysm implant (pCONus)
  • Diagnostic Impact of Bone-Subtraction CT Angiography for Patients with Acute Subarachnoid Hemorrhage
  • Single-Layer WEBs: Intrasaccular Flow Disrupters for Aneurysm Treatment--Feasibility Results from a European Study
  • HydroCoils Are Associated with Lower Angiographic Recurrence Rates Than Are Bare Platinum Coils in Treatment of "Difficult-to-Treat" Aneurysms: A Post Hoc Subgroup Analysis of the HELPS Trial
  • Coil Occlusion of Wide-Neck Bifurcation Aneurysms Assisted by a Novel Intra- to Extra-Aneurysmatic Neck-Bridging Device (pCONus): Initial Experience
  • Standard of practice: embolization of ruptured and unruptured intracranial aneurysms
  • Intrasaccular Flow-Disruption Treatment of Intracranial Aneurysms: Preliminary Results of a Multicenter Clinical Study
  • Aneurysm Ostium Angle: A Predictor of the Need for Stent as Assistance for Endovascular Aneurysm Coiling in Internal Carotid Artery Sidewall Aneurysms
  • Stent-Assisted Coiling of Complex Middle Cerebral Artery Aneurysms: Initial and Midterm Results
  • Crossref
  • Google Scholar

This article has not yet been cited by articles in journals that are participating in Crossref Cited-by Linking.

More in this TOC Section

  • Prophylactic Endovascular Treatments for CBS
  • Smoking & Aneurysm Outcomes: A Meta-Analysis
  • “Buddy-wire anchoring” technique for TVE
Show more NEUROINTERVENTION

Similar Articles

Advertisement

Indexed Content

  • Current Issue
  • Accepted Manuscripts
  • Article Preview
  • Past Issues
  • Editorials
  • Editor's Choice
  • Fellows' Journal Club
  • Letters to the Editor
  • Video Articles

Cases

  • Case Collection
  • Archive - Case of the Week
  • Archive - Case of the Month
  • Archive - Classic Case

More from AJNR

  • Trainee Corner
  • Imaging Protocols
  • MRI Safety Corner
  • Book Reviews

Multimedia

  • AJNR Podcasts
  • AJNR Scantastics

Resources

  • Turnaround Time
  • Submit a Manuscript
  • Submit a Video Article
  • Submit an eLetter to the Editor/Response
  • Manuscript Submission Guidelines
  • Statistical Tips
  • Fast Publishing of Accepted Manuscripts
  • Graphical Abstract Preparation
  • Imaging Protocol Submission
  • Evidence-Based Medicine Level Guide
  • Publishing Checklists
  • Author Policies
  • Become a Reviewer/Academy of Reviewers
  • News and Updates

About Us

  • About AJNR
  • Editorial Board
  • Editorial Board Alumni
  • Alerts
  • Permissions
  • Not an AJNR Subscriber? Join Now
  • Advertise with Us
  • Librarian Resources
  • Feedback
  • Terms and Conditions
  • AJNR Editorial Board Alumni

American Society of Neuroradiology

  • Not an ASNR Member? Join Now

© 2025 by the American Society of Neuroradiology All rights, including for text and data mining, AI training, and similar technologies, are reserved.
Print ISSN: 0195-6108 Online ISSN: 1936-959X

Powered by HighWire
Email this Article

Thank you for your interest in spreading the word on American Journal of Neuroradiology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Difficult Aneurysms for Endovascular Treatment: Overwide or Undertall?
(Your Name) has sent you a message from American Journal of Neuroradiology
(Your Name) thought you would like to see the American Journal of Neuroradiology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Cite this article
W. Brinjikji, H.J Cloft, D.F. Kallmes
Difficult Aneurysms for Endovascular Treatment: Overwide or Undertall?
American Journal of Neuroradiology Sep 2009, 30 (8) 1513-1517; DOI: 10.3174/ajnr.A1633

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

We use cookies on this site to enhance your user experience. By clicking any link on this page you are giving your consent for us to set cookies.