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Hemorrhagic stroke
Original research
Analysis of endovascular treatment of ruptured microaneurysms compared with ruptured larger aneurysms
  1. Eduardo Murias Quintana1,
  2. Pedro Vega1,
  3. Edison Morales1,
  4. Alberto Gil2,
  5. Hugo Cuellar3,
  6. Pedro Navia4,
  7. Antonio Saiz1,
  8. Angela Meilán1,
  9. Maria Cadenas5,
  10. Davinia Larrosa6,
  11. Julio Cesar Gutierrez-Morales7,
  12. Antonio Lopez7
  1. 1Department of Radiology—Interventional Neuroradiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  2. 2Department of Radiology—Interventional Neuroradiology, Hospital Universitario de Cruces, Bilbao, Spain
  3. 3Department of Neurosurgery, LSU Health Sciences Center, Shreveport, Louisiana, USA
  4. 4Department of Radiology—Interventional Neuroradiology, Hospital Universitario Donostia, San Sebastian, USA
  5. 5Department of Radiology, Hospital Universitario Central de Asturias Oviedo, Asturias, Spain
  6. 6Department of Neurology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  7. 7Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain
  1. Correspondence to Dr Eduardo Murias Quintana, Hospital Universitario Central de Asturias, Radiology—Interventional Neuroradiology, Julián Clavería s/n, Oviedo, Asturias 33006, Spain; emuriass{at}hotmail.com

Abstract

Objective To retrospectively analyze the complications and outcome of the endovascular treatment of ruptured microaneurysms compared with the treatment of ruptured larger aneurysms.

Methods 40 ruptured cerebral microaneurysms treated by endovascular techniques were selected retrospectively and compared with 207 larger ruptured cerebral aneurysms treated by endovascular techniques during the same time period. Medical charts and imaging studies were reviewed to analyze baseline clinical and epidemiologic characteristics, procedural complications, and clinical outcomes

Results Cerebral microaneurysms had a higher incidence of intraoperative technical ruptures (13.5% vs 2.9%, p<0.005). The number of thromboembolic complications was not increased. Patient prognosis was similar for the two groups (mean modified Rankin Scale score 1.81 vs 2.09, p>0.1).

Conclusions Coiling of cerebral microaneurysms has a reasonable safety profile with good clinical outcomes, similar to coiling of larger aneurysms. In our experience, the systematic use of remodeling balloons, operator experience, and the ability to manage complications are the reasons for the satisfactory results.

  • Aneurysm
  • Angiography
  • Hemorrhage
  • Subarachnoid

https://doi.org/10.1136/neurintsurg-2015-011660

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