J Korean Neurosurg Soc.  2009 Jan;45(1):5-10. 10.3340/jkns.2009.45.1.5.

Clinical and Radiogical Outcomes of Endovascular Detachable Coil Embolization in Paraclinoid Aneurysms : A 10-Year Experience

• Jin SC
• Kwon DH
• Ahn JS
• Kwun BD
• Song Y
• Choi CG

• KMID: 1466336
• DOI: http://doi.org/10.3340/jkns.2009.45.1.5

Abstract

OBJECTIVE
Direct surgical clipping of paraclinoid aneurysms poses technical challenges to even very experienced neurosurgeons, making endovascular treatment an alternative treatment modality in many centers. We have therefore retrospectively evaluated the safety and efficacy of endovascular detachable coil embolization of paraclinoid aneurysms.
METHODS
From June 1997 to June 2007, 65 patients underwent endovascular detachable coiling for 67 paraclinoid aneurysms (of which 9 were ruptured and 58 were unruptured) in our institute. Their medical records, radiological images and readings, and operation records were reviewed retrospectively.
RESULTS
After the initial embolization procedure, complete occlusion was achieved in 29 (43.3%) of the aneurysms treated by endovascular detachable coiling. Six aneurysms required retreatment, with two each requiring one, two, or three additional endovascular procedures. Fifty-five (82.1%) aneurysms were measured by three-dimensional time of flight (TOF) magnetic resonance images (MRI) or transfemoral cerebral angiography (TFCA) at a mean follow-up of 29.7 months (range from 4 to 94 months), with 39 aneurysms (70.9%) showing complete occlusion. Thromboembolic events (3.8%) were the most frequent complication. Rupture did not occur during or after any of the procedures. According to the Glasgow Outcome Scale (GOS), 98.4% of the patients treated by coil embolization had a score of 4 or 5.
CONCLUSION
Our results indicate that endovascular detachable coiling is a safe and effective treatment modality in paraclinoid aneurysms.

Keyword

Paraclinoid; Aneurysms; Endovascular

MeSH Terms

Aneurysm
Cerebral Angiography
Endovascular Procedures
Follow-Up Studies
Glasgow Outcome Scale
Humans
Magnetic Resonance Spectroscopy
Medical Records
Reading
Retreatment
Retrospective Studies
Rupture
Surgical Instruments