Endovascular Treatment of Intracranial Aneurysms Concomitant with Severe Adjacent Atherosclerotic Stenosis.

Endovascular Treatment of Intracranial Aneurysms Concomitant with Severe Adjacent Atherosclerotic Stenosis.

World Neurosurg. 2018 Jan 08;:

Authors: Gao BL, Li ZS, Li TX, Xue JY, Feng G, Wang ZL, Bai WX, Zhao TY, Liang XD

Abstract
PURPOSE: To investigate the effect and safety of endovascular treatment of intracranial aneurysms concomitant with severe adjacent atherosclerotic stenosis.
MATERIALS AND METHODS: Twenty-six patients with aneurysms and adjacent stenosis were prospectively enrolled. The characteristics of the aneurysm, parent artery, atherosclerotic stenosis and endovascular treatment methods were analyzed.
RESULTS: All aneurysms were successfully embolized (100%), with stent-assisted coiling in forteen (53.8%) cases, coiling alone in ten (38.5%), double microcatheter coiling in one (3.8%) and balloon assisted coiling in the remaining one (3.8%). Immediately following embolization, complete occlusion was achieved in ten cases (38.5%), nearly complete occlusion in six (23.1%) and non-complete occlusion in ten (38.5%). Ten aneurysms were of Type I and were managed with coiling alone in eight cases and stent-assisted coiling in the remaining two cases, achieving complete occlusion in six cases (60%), nearly complete in two (20%) and non-complete in the other two (20%). Sixteen aneurysms were of type II and treated with stent-assisted coiling in twelve cases (75%), single coiling in two (12.5%), double microcatheters in one (6.3%) and balloon-assisted coiling in the remaining one (6.3%). Aneurysm occlusion was complete in four cases (25%), nearly complete in four (25%) and non-complete in the other eight (50%). Clinical follow-up of 2 months to 5 years (mean 26±11 months) demonstrated no rebleeding, with the mRS score of 0-2 in twenty patients, 3 in four and six in the remaining two.
CONCLUSION: Intracranial aneurysms concomitant with severe adjacent atherosclerotic stenosis can be successfully treated endovascularly, and careful evaluation of the characteristics of the aneurysm, parent artery, stenosis and collateral circulation can help reducing complications.

PMID: 29325952 [PubMed - as supplied by publisher]

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