RT Journal Article
SR Electronic
T1 Endovascular treatment of fusiform intracranial aneurysms
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 110
OP 116
DO 10.1136/neurintsurg-2011-010233
VO 5
IS 2
A1 Kavi K Devulapalli
A1 Shakeel A Chowdhry
A1 Nicholas C Bambakidis
A1 Warren Selman
A1 Daniel Pierce Hsu
YR 2013
UL http://jnis.bmj.com/content/5/2/110.abstract
AB Background and purpose Endovascular treatment (EVT) has emerged as an alternative therapeutic strategy for the treatment of intracranial fusiform aneurysms (IFAs), but little is known about the safety and efficacy of deconstructive and reconstructive methods, especially in patients presenting with subarachnoid hemorrhage (SAH). The purpose of this study is to describe the radiological and clinical outcomes in patients with IFAs undergoing EVT. Methods A retrospective analysis was conducted of 18 patients undergoing EVT of IFAs, 13 of whom (72.2%) presented with SAH. Radiological outcomes were characterized by the presence of parent vessel opacification and aneurysmal remnants for patients undergoing deconstructive and reconstructive EVT, respectively. Clinical outcomes were characterized by the Glasgow Outcome Scale. Contingency analysis of factors associated with clinical outcomes in patients with ruptured aneurysms was conducted. Results Technical success was achieved in 17 of the 18 patients (94.4%), with 10 (55.6%) undergoing reconstructive EVT and eight (44.4%) undergoing deconstructive EVT. For patients with SAH, favorable clinical outcomes were achieved in 9/13 (69.2%), with 3/6 (50.0%) undergoing reconstructive EVT and 6/7 (85.7%) undergoing deconstructive EVT. Among patients with ruptured aneurysms, only Hunt–Hess grade ≥3 was associated with an unfavorable clinical outcome (p=0.007). Favorable clinical outcomes were seen in all five patients with unruptured aneurysms. Conclusion Both deconstructive and reconstructive EVT were found to be safe and effective in patients with unruptured aneurysms. Reconstructive EVT may be associated with a higher incidence of poor clinical outcomes in patients presenting with high-grade SAH.