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Unruptured intracranial aneurysms treated by three-dimensional coil embolization: evaluation of the postoperative aneurysm occlusion volume

  • Interventional Neuroradiology
  • Published:
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Abstract

Our purpose was to evaluate the postoperative aneurysm occlusion volume and clinical results of treating unruptured intracranial aneurysm using three-dimensional (3D) coils. Over a 2-year period 62 aneurysms (39 with a neck ≤4 mm, 23 with a neck >4 mm) in 62 patients in five participating centres were treated. The procedure consisted, firstly, of framing the aneurysm with one or more spherical 3D coils, and secondly, of filling it with two-dimensional (2D) helical coils. Anatomical and clinical results were evaluated by univariate analysis. Multivariate analysis was used to identify independent predictors of these results. For neck sizes ≤4 and >4 mm, angiographic occlusion was complete in 31 (79%) and 16 (70%) aneurysms, respectively; the mean percentage of occlusion volume was 31.4% and 29.5%, respectively, and postoperative morbidity was 3% and 4%, respectively, with no significant differences between the two groups. There were no deaths. However, occlusion volume correlated with sac size (P=0.037) and sac-to-neck ratio <1.5 (P=0.073), except when three or more 3D coils per aneurysm were used (P=0.516 and P=0.308, respectively). Occlusion volume correlated with the number of 3D coils per aneurysm (P<0.001) and was an independent predictor of angiographic complete occlusion (P=0.002). The use of the largest number of 3D coils per aneurysm was safe and may improve the postoperative volume and angiographic occlusion of aneurysms with a neck >4 mm, provided the sac-to-neck ratio is ≥1.5.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Medical Université of Paris 6, 47-83 Bd de l’Hôpital, 75651, Cedex 13, Paris, France

    Jean-Noël Vallée, Francisco Mont’Alverne, Daouda Lo, Hector M Barragan-Campos, Remy Guillevin & Jacques Chiras

  2. Department of Radiology, Hôpital Maison Blanche, Reims, France

    Laurent Pierot

  3. Department of Diagnostic and Interventional Neuroradiology, Hôpital Neurologique, Lyon, France

    Francis Turjman & Betty Jean

  4. Department of Diagnostic and Interventional Neuroradiology, Hôpital Gui de Chauillac, Montpellier, France

    Alain Bonafé

  5. Department of Diagnostic and Interventional Neuroradiology, Hôpital Neurologique, Nancy, France

    Serge Bracard

  6. Department of Neurology and Neurovascular Emergency, Hôpital la Pitié-Salpêtrière, Paris, France

    Sophie Crozier

  7. Department of Neurosurgery, Hôpital la Pitié-Salpêtrière, Paris, France

    Hugues Duffau

Authors
  1. Jean-Noël Vallée
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  2. Laurent Pierot
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  3. Francisco Mont’Alverne
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  4. Francis Turjman
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  5. Alain Bonafé
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  6. Serge Bracard
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  7. Daouda Lo
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  8. Sophie Crozier
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  9. Hugues Duffau
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  10. Hector M Barragan-Campos
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  11. Betty Jean
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  12. Remy Guillevin
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  13. Jacques Chiras
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Correspondence to Jean-Noël Vallée.

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Vallée, JN., Pierot, L., Mont’Alverne, F. et al. Unruptured intracranial aneurysms treated by three-dimensional coil embolization: evaluation of the postoperative aneurysm occlusion volume. Neuroradiology 47, 438–445 (2005). https://doi.org/10.1007/s00234-004-1320-1

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  • DOI: https://doi.org/10.1007/s00234-004-1320-1

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