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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 594-600
DOI: 10.4103/ajns.AJNS_248_20
Original Article

Success rate of simple coil embolization in wide-neck aneurysm with aneurysmal shoulder

Payothorn Decharin
1   Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
,
Anchalee Churojana
1   Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
2   Siriraj Center of Interventional Radiology, Siriraj Hospital, Bangkok
,
Thaweesak Aurboonyawat
2   Siriraj Center of Interventional Radiology, Siriraj Hospital, Bangkok
3   Department of Surgery, Neurosurgery Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
,
Ekawut Chankaew
2   Siriraj Center of Interventional Radiology, Siriraj Hospital, Bangkok
3   Department of Surgery, Neurosurgery Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
,
Dittapong Songsaeng
1   Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
,
Boonrerk Sangpetngam
1   Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
2   Siriraj Center of Interventional Radiology, Siriraj Hospital, Bangkok
,
Pattarawit Withayasuk
1   Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
2   Siriraj Center of Interventional Radiology, Siriraj Hospital, Bangkok
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Background and Objective: Wide-necked intracranial aneurysm (WIA) is one of the challenging diseases for neuro-interventionist to treat by simple coiling technique. The purpose of this study is to identify the morphology associated with successful simple coil embolization in wide neck aneurysm patients. Materials and Methods: Between January 2002 and August 2018, 102 patients with total 115 ruptured or unruptured WIA which received endovascular treatment were retrospective reviewed. Data were analyzed including demographics, aneurysm morphology, endovascular technique, angiographic outcome, complication, regrowth, and retreatment rate. Results: The mean age of patients was 61.6 years with female predominant (72.5%). Ruptured WIA was diagnosed in 71 patients (61.7%). Majority of aneurysms were located in an anterior circulation which were 74 cases (64.3%), mainly paraclinoid aneurysm (30/115). Endovascular treatment was successful in 113 cases (98.3%) which can be mainly divided into simple coil embolization 50 cases (43.5%), balloon-assisted coil embolization 26 cases (22.6%), and stent-assisted coil embolization 32 cases (27.8%). Complete, subtotal, and incomplete occlusion of WIA was achieved in 32 cases (27.8%), 62 cases (53.9%), and 18 cases (15.7%), respectively. There was 9.6% complication occurred. Regrowth and retreatment were found 20% and 15.7%, respectively. Conclusion: WIA with two-sided aneurysmal shoulder or neck width <3.6 mm. are significantly associated with successful coil embolization using simple coiling technique.

Key-words:

Aneurysmal shoulder - coil embolization - intracranial aneurysm - shoulder of aneurysm - wide-necked aneurysm

Financial support and sponsorship

Nil.




Publication History

Received: 22 May 2020

Accepted: 22 June 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Chalouhi N, Hoh BL, Hasan D. Review of cerebral aneurysm formation, growth, and rupture. Stroke 2013;44:3613-22.
  • 2 Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, et al. International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomised trial. Lancet 2002;360:1267-74.
  • 3 Debrun GM, Aletich VA, Kehrli P, Misra M, Ausman JI, Charbel F. Selection of cerebral aneurysms for treatment using Guglielmi detachable coils: The preliminary University of Illinois at Chicago experience. Neurosurgery 1998;43:1281-95.
  • 4 Fernandez Zubillaga A, Guglielmi G, Viñuela F, Duckwiler GR. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: Correlation of aneurysm neck size and treatment results. AJNR Am J Neuroradiol 1994;15:815-20.
  • 5 Gonzalez N, Sedrak M, Martin N, Vinuela F. Impact of anatomic features in the endovascular embolization of 181 anterior communicating artery aneurysms. Stroke 2008;39:2776-82.
  • 6 Hope JK, Byrne JV, Molyneux AJ. Factors influencing successful angiographic occlusion of aneurysms treated by coil embolization. AJNR Am J Neuroradiol 1999;20:391-9.
  • 7 Turjman F, Massoud TF, Sayre J, Viñuela F. Predictors of aneurysmal occlusion in the period immediately after endovascular treatment with detachable coils: A multivariate analysis. AJNR Am J Neuroradiol 1998;19:1645-51.
  • 8 Cloft HJ, Joseph GJ, Tong FC, Goldstein JH, Dion JE. Use of three-dimensional Guglielmi detachable coils in the treatment of wide-necked cerebral aneurysms. AJNR Am J Neuroradiol 2000;21:1312-4.
  • 9 Ahn JM, Oh JS, Yoon SM, Shim JH, Oh HJ, Bae HG. Procedure-related complications during endovascular treatment of intracranial saccular aneurysms. J Cerebrovasc Endovasc Neurosurg 2017;19:162-70.
  • 10 Brinjikji W, Cloft HJ, Kallmes DF. Difficult aneurysms for endovascular treatment: Overwide or undertall? AJNR Am J Neuroradiol 2009;30:1513-7.
  • 11 Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke 2001;32:1998-2004.
  • 12 Zhao B, Yin R, Lanzino G, Kallmes DF, Cloft HJ, Brinjikji W. Endovascular coiling of wide-neck and wide-neck bifurcation aneurysms: A systematic review and meta-analysis. AJNR Am J Neuroradiol 2016;37:1700-5.
  • 13 McLaughlin N, McArthur DL, Martin NA. Use of stent-assisted coil embolization for the treatment of wide-necked aneurysms: A systematic review. Surg Neurol Int 2013;4:43.
  • 14 Ferns SP, Sprengers ME, van Rooij WJ, Rinkel GJ, van Rijn JC, Bipat S, et al. Coiling of intracranial aneurysms: A systematic review on initial occlusion and reopening and retreatment rates. Stroke 2009;40:e523-9.
  • 15 Withayasuk P, Churojana A, Songsaeng D, Aurboonyawat T, Chankaew E. Favorable outcome of endovascular treatment for intracranial aneurysms: A single-center study in Thailand. Asian J Neurosurg 2018;13:721-9.
  • 16 Ihn YK, Shin SH, Baik SK, Choi IS. Complications of endovascular treatment for intracranial aneurysms: Management and prevention. Interv Neuroradiol 2018;24:237-45.