Journal of Korean Neurosurgical Society

  • 제49권2호
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  • Pages.97-101
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  • 2011
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Endovascular Treatment of Wide-Necked Intracranial Aneurysms : Techniques and Outcomes in 15 Patients

  • Kim, Jin-Wook (Department of Neurosurgery, Kosin University College of Medicine) ;
  • Park, Yong-Seok (Department of Neurosurgery, Kosin University College of Medicine)
  • 투고 : 2010.11.18
  • 심사 : 2011.02.04
  • 발행 : 2011.02.28
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초록

Objective : It is technically difficult to treat wide-necked intracranial aneurysms by the endovascular method. Various tools and techniques have been introduced to overcome the related technical limitations. The purpose of this study was to evaluate the radiologic and clinical results of widenecked intracranial aneurysm treatment using the endovascular method. Methods : Fifteen aneurysms in 15 patients were treated by the endovascular method from October 2009 to August 2010. Seven patients presented with subarachnoid hemorrhage (SAH), seven patients had unruptured aneurysms, and one patient had an intracerebral hemorrhage and intraventricular hemorrhage due to an incompletely clipped aneurysm. The mean dome-to-neck ratio was 1.1 (range, 0.6-1.7) and the mean height-to-neck ratio was 1.1 (range, 0.6-2.0). We used double microcatheters instead of a stent or a balloon for the first trial. When we failed to make a stable coil frame with two coils, we used a stent-assisted technique. Results : All aneurysms were successfully embolized. Eleven aneurysms (73%) were embolized by the double microcatheter technique without stent insertion, and four aneurysms (27%) were treated by stent-assisted coil embolization. One case had subclinical procedure-related intraoperative hemorrhage. Another case had procedure-related thromboembolism in the left distal anterior cerebral artery. During the follow-up period, one patient (7%) had a recanalized aneurysmal neck 12 months after coil embolization. The recurrent aneurysm was treated by stent-assisted coil embolization. Conclusion : We successfully treated 15 wide-necked intracranial aneurysms by the endovascular method. More clinical data with longer follow-up periods are needed to establish the use of endovascular treatment for wide-necked aneurysm.

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참고문헌

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피인용 문헌

  1. Coiling after Treatment with the Woven EndoBridge Cerebral Aneurysm Embolization Device : A Case Report vol.18, pp.2, 2011, https://doi.org/10.1177/159101991201800214
  2. Y-Configuration Stent Placement (Crossing and Kissing) for Endovascular Treatment of Wide-Neck Cerebral Aneurysms Located at 4 Different Bifurcation Sites vol.33, pp.7, 2011, https://doi.org/10.3174/ajnr.a2961
  3. Endovascular Treatment of Wide-Neck, Ruptured and Unruptured Aneurysms without Supporting Devices : A Single Center Experience vol.26, pp.1, 2013, https://doi.org/10.1177/197140091302600117
  4. Comparison of clinical and radiologic outcomes among stent-assisted, double-catheter, and balloon-assisted coil embolization of wide neck aneurysms vol.156, pp.7, 2014, https://doi.org/10.1007/s00701-014-2104-y
  5. Angiographic Results of Wide-Necked Intracranial Aneurysms Treated with Coil Embolization : A Single Center Experience vol.57, pp.4, 2015, https://doi.org/10.3340/jkns.2015.57.4.250
  6. Endovascular Treatment of Wide Neck Aneurysms vol.6, pp.12, 2011, https://doi.org/10.3889/oamjms.2018.443
  7. Coil migration during or after endovascular coiling of cerebral aneurysms vol.12, pp.5, 2011, https://doi.org/10.1136/neurintsurg-2019-015278
  8. Early experience treating intracranial aneurysms using Accero: a novel, fully visible, low profile braided stent with platinum–nitinol composite wire technology vol.13, pp.1, 2011, https://doi.org/10.1136/neurintsurg-2020-015918