Yeungnam Univ J Med.  2019 Sep;36(3):208-218. 10.12701/yujm.2019.00192.

Feasibility and efficacy of coil embolization for middle cerebral artery aneurysms

Affiliations
  • 1Department of Neurosurgery, Kosin University Gospel Hospital, Busan, Korea.
  • 2Department of Neurosurgery, Pusan National University Hospital, Busan, Korea. chwachoi@pusan.ac.kr
  • 3Department of Diagnostic Radiology, Pusan National University Hospital, Busan, Korea.

Abstract

BACKGROUND
The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms.
METHODS
From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed.
RESULTS
Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only 3 aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, 5 (6.9%) remnant neck, and 1 (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of 8 asymptomatic and 2 symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included 1 major and 3 minor recanalizations.
CONCLUSION
Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.

Keyword

Coil embolization; Intracranial aneurysm; Middle cerebral artery

MeSH Terms

Aneurysm
Embolization, Therapeutic*
Follow-Up Studies
Hemorrhage
Humans
Intracranial Aneurysm*
Middle Cerebral Artery*
Mortality
Neck
Retrospective Studies
Rupture
Stents
Surgical Instruments
Thromboembolism
Full Text Links
  • YUJM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error