Journal of Korean Neurosurgical Society

  • 제57권3호
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  • Pages.159-166
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  • 2015
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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 429 Anterior Communicating Artery Aneurysms Using Bare-Platinum Coils : Clinical and Radiologic Outcomes at the Long-term Follow-up

  • Lee, Jong Young (Department of Neurosurgery, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine) ;
  • Seo, Jeong Hwa (Department of Neurology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Cho, Young Dae (Department of Radiology, Seoul National University College of Medicine) ;
  • Kang, Hyun-Seung (Department of Neurosurgery, Seoul National University College of Medicine) ;
  • Han, Moon Hee (Department of Radiology, Seoul National University College of Medicine)
  • 투고 : 2014.02.19
  • 심사 : 2014.08.01
  • 발행 : 2015.03.28
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초록

Objective : We reviewed the feasibility, safety and efficacy as well as the clinical outcome and long-term angiographic results of endovascular treatment (EVT) of the anterior communicating artery (ACoA) aneurysms. Methods : A total of 429 ACoA aneurysms in 426 patients were treated using coil embolization between March 1996 and October 2010 in a single institution. Pretreatment aneurysmal features were checked using angiogram. We had usually used tailored steam shaped microcatheter according to individual angiographic architectures. Immediate postembolization outcomes were evaluated using an angiographic outcome scale and clinical evaluation was performed using the Glasgow Outcome Scale (GOS). Results : Postembolization angiograms demonstrated total occlusion of aneurysm in 290 of 429 (67.6%) aneurysms, neck remnant in 80 (18.6%) and body filling in 59 (13.8%). Dome direction and aneurysm angle was not associated with initial angiographic outcomes. The procedure-related morbidity rate was 0.9% (4 of 429). Clinical and imaging follow-up more than 6 months were available in 382 (89.0%) patients with a mean of 26.2 months. Overall rate of major recanalization was 7.9% (30 of 382) and all of them were retreated without complications. At the last follow-up, 233 (99.2%) of 235 patients had GOS of 5 in unruptured group, and 152 (79.5%) of 191 patients showed good clinical outcomes (GOS of 4 or 5) in ruptured group. Conclusion : Tailored steam shaping of the microcatheter is vital to achieve good angiographic outcomes regardless of aneurysmal direction. EVT is feasible and safe for most ACoA aneurysms with acceptable immediate and long-term outcomes.

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참고문헌

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