RT Journal Article
SR Electronic
T1 Endovascular Treatment of Wide-Neck Intracranial Aneurysms Using a Microcatheter Protective Technique: Results and Outcomes in 75 Aneurysms
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 917
OP 922
DO 10.3174/ajnr.A2411
VO 32
IS 5
A1 Lee, J.Y.
A1 Seo, J.H.
A1 Cho, Y.D.
A1 Kang, H.-S.
A1 Han, M.H.
YR 2011
UL http://www.ajnr.org/content/32/5/917.abstract
AB BACKGROUND AND PURPOSE: The microcatheter protective technique positions an additional microcatheter in the parent or side-branching artery to protect it during coil embolization. The purpose of this study was to describe this method and to evaluate its efficacy and safety as an alternative to a multiple-microcatheter or balloon- or stent-assisted technique for wide-neck aneurysms. MATERIALS AND METHODS: A retrospective review of 74 patients (43 women; mean age, 59.6 years) with 75 wide-neck aneurysms treated with the microcatheter protective technique between January 2003 and April 2010 was performed. Immediate postembolization angiograms were evaluated by using a conventional angiographic scale, and clinical evaluation was performed by using the GOS. Clinical and imaging follow-up were available in 57 (76%) patients, with a mean of 14.7 months. RESULTS: Postembolization angiograms demonstrated total occlusion in 45 of 75 (60%) aneurysms, a neck remnant in 17 (22.7%), and body filling in 13 (17.3%). The technique-related complication rate was 17.4% (13/75), and the procedural-related morbidity rate was 1.3% (1/74). All patients, except 3 complicated cases with a GOS of <4, had a GOS of 5 at the end of the study period. Of the 57 aneurysms with follow-up, recanalization developed in 5 (8.8%) aneurysms, and 3 (5.3%) cases of major recanalization were re-treated endovascularly. CONCLUSIONS: The microcatheter protective technique is feasible and safe for coil embolization of wide-neck aneurysms, especially in cases that are not suitable for multiple catheter or balloon- or stent-assisted techniques. AcomAanterior communicating arteryDSAdigital subtraction angiographyEVDexternal ventricular drainGOSGlasgow Outcome ScaleHunt and HessHHSAHsubarachnoid hemorrhagevPDvolumetric packing density