Unit:
Κατεύθυνση Επεμβατική ΑκτινολογίαLibrary of the School of Health Sciences
Author:
Stefanidis Petros
Supervisors info:
Παπαθανασίου Ματίλντα, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ (Επιβλέπον μέλος)
Σπηλιόπουλος Σταύρος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μαγκούφης Γεώργιος, Διευθυντής, Metropolitan Hospital
Original Title:
Ενδαγγειακή αντιμετώπιση ανευρυσμάτων μέσης εγκεφαλικής αρτηρίας
Translated title:
Endovascular treatment of middle cerebral artery aneurysms
Summary:
Introduction: The advances on the endovascular techniques and the technological improvement of the materials and the equipment have established the endovascular embolization of the cerebral aneurysms as the first choice of treatment.
Materials and Methods: We obtained retrospectively medical records of patients that suffered from ruptured aneurysms of MCA from January 2015 until December 2018. We included 22 patients who were treated endovascularly. All patients were clinically evaluated using the Hunt and Hess grading scale.
Results: In 17 patients (77.3%), the aneurysm was totally occluded; four (18.2%) patients the occlusion rate was between 95 and 99%; one patient (4.5%) the occlusion rate was less than 95%. After the 6 month the occlusion rate was about 100% in 17 patients (77.3%), between 95 and 99% in 2 patients (9.1%) and less than 95% in three patients (13.6%). Severe angiographic vasospasm was observed in three patients (13.6%) while clinical angiospasm without severe symptoms was observed in 9 patients (40.9%). Intraprocedural thromboembolic events occurred in two patients (9.1%). Rupture of the aneurysm occurred in one procedure (4.5%) during the deposition of the coils. Three patients (13.6%) the aneurysms relapsed and they needed second intervention to achieve total occlusion of the aneurysm. The 30 days mortality rate of the procedures was null.
Conclusion: Endovascular coil embolization of MCA aneurysms is an effective and relatively safe technique and can be performed with acceptable mortality and morbidity. The evolution of the materials used for embolization with proper and continuous training will lead to even better results. Nevertheless, surgical clipping will continue to play an important role in the treatment of aneurysms that cannot be occluded with coils.
Main subject category:
Health Sciences
Keywords:
Aneurysm, Brain, Endovascular
File:
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aneurysm MCA.pdf
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