Article Figures & Data
Figures
- Fig 1.
A, This 50-year-old woman was admitted with a WFNS grade I SAH with a thick clot localized around the right carotid cistern (axial noncontrast CT scan). B and C, She was found to have a 9-mm elongated right superior hypophyseal aneurysm (B, oblique projection) for which coil embolization was performed with near-complete occlusion (C, oblique projection). D, A follow-up DSA 6 months later showed recurrence of the aneurysm (oblique projection). The recurrence was treated with a Pipeline Embolization Device (PED, Chestnut Medical Technologies, Menlo Park, California). E and F, Oblique projections, early arterial phase (E) and late venous phase (F) after PED deployment, show stasis of contrast within the recurrent portion of the neck.
Tables
Ruptured Paraclinoid Sex F 27 (82%) M 6 (18%) F/M 4.5 Mean age (yr) 52.9 ± 14.3 Risk factors Hypertension 41% Diabetes mellitus 3% Tobacco abuse Current 55% Prior 3% Personal history of stroke 9% Family history of intracranial aneurysm 11% History of SAH 3% Pretreatment mRS (before SAH) 0 52% 1 42% 3 3% 4 3% Interval between SAH and treatment <24 Hr 26 (79%) ≥24 ≤ 48 Hr 2 (6%) ≥48 Hr 5 (15%) Length of hospital stay (days) 16.1 ± 11.9 Aneurysm Location Size Small (<10 mm) Large (10–25 mm) Giant (>25 mm) Total Clinoid segment (C5) 15 1 1 52% Ophthalmic segment (C6) 11 5 0 48% Scale Grade WFNS I 20 (61%) II 4 (12%) III 2 (6%) IV 3 (9%) V 4 (12%) Fisher Grade 1 3 (9%) 2 4 (12%) 3 17 (52%) 4 9 (27%) Occlusion Grade Immediate 6 Mo 12 Mo Last Follow-Up Class 1 12/33 (36%) 7/14 (50%) 5/12 (42%) 9/13 (69%) Class 2 16/33 (48%) 5/14 (36%) 6/12 (50%) 4/13 (31%) Class 3 5/33 (15%) 2/14 (14%) 1/12 (8%) – Occlusion Grade (Raymond class) Immediate Follow-Up Class 1 7/23 (30%) 15/23 (65%) Class 2 13/23 (57%) 7/23 (31%) Class 3 3/23 (13%) 1/23 (4%) -
Occlusion grade scored with Raymond class.
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↵a Comparative results between immediate and delayed angiographic occlusion grade in a restricted subgroup of patients with radiology at any time during the follow-up.
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Within 6 Mo Within 12 Mo At the Last Follow-Up 3 2 2 -
↵a Retreatment interval since initial intervention for 7 patients during the follow-up.
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