Journal of Korean Neurosurgical Society

  • 제64권5호
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  • Pages.751-762
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  • 2021
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Comparison of Long-Term Angiographic Results of Wide-Necked Intracranial Aneurysms : Endovascular Treatment with Single-Microcatheter Coiling, Double-Microcatheter Coiling, and Stent-Assisted Coiling

  • Kim, Hyun Sik (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Cho, Byung Moon (Department of Neurosurgery, Kangdong Sacred Heart Hospital) ;
  • Yoo, Chan Jong (Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine) ;
  • Choi, Dae Han (Department of Neurosurgery, Gil Medical Center, Gachon University College of Medicine) ;
  • Hyun, Dong Keun (Department of Neurosurgery, College of Medicine, Inha University) ;
  • Shim, Yu Shik (Department of Neurosurgery, College of Medicine, Inha University) ;
  • Song, Joon Ho (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Oh, Jae Keun (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Ahn, Jun Hyong (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Kim, Ji Hee (Department of Neurosurgery, Hallym University Sacred Heart Hospital) ;
  • Chang, In Bok (Department of Neurosurgery, Hallym University Sacred Heart Hospital)
  • 투고 : 2021.01.13
  • 심사 : 2021.05.21
  • 발행 : 2021.09.01
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초록

Objective : Endovascular treatment of intracranial aneurysms is challenging in case of wide-necked aneurysms because coils are prone to herniate into the parent artery, causing thromboembolic events or vessel occlusion. This study aims to compare long-term angiographic results of wide-necked aneurysms treated by stent-assisted, double-microcatheter, or single-microcatheter groups. Methods : Between January 2003 and October 2016, 108 aneurysms that were treated with endovascular coil embolization with a neck size wider than 4 mm and a follow-up period of more than 3 years were selected. We performed coil embolization with single-microcatheter, double-microcatheter, and stent-assisted techniques. Angiographic results were evaluated using the Raymond-Roy occlusion classification (RROC). All medical and angiographic records were reviewed retrospectively. Results : Clinical and angiographic analyses were conducted in 108 wide-necked aneurysms. The immediate post-procedural results revealed RROC class I (complete occlusion) in 66 cases (61.1%), class II (residual neck) in 36 cases (33.3%), and class III (residual sac) in six cases (5.6%). The final follow-up results revealed class I in 48 cases (44.4%), class II in 49 cases (45.4%), and class III in 11 cases (10.2%). Of a total of 45 (41.6%) radiologic recurrences, there were 21 cases (19.4%) of major recurrence that required additional treatment, and 24 cases (22.2%) of minor recurrence. The final follow-up angiographic results showed statistically significant differences between the stent-assisted group and the others (p<0.01). Conclusion : Long-term follow-up angiography demonstrated that the stent-assisted technique had a better complete occlusion rate than the other two techniques.

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참고문헌

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