[Experience with endovascular occlusion of cerebrovascular aneurysms by means of microspirals].
The paper summarizes the outcomes of endovascular treatment of 42 patients (19 males and 23 females) aged 24 to 68 years who had cerebrovascular aneurysms, 7 of them were operated on in the acute phase of subarachnoidal hemorrhage. There were small [n = 27 (61.4%)], large [n = 14 (31.8%)], and giant [n = 3 (6.8%)] aneurysms. According to their site, aneurysms were found in the internal carotid [n = 22 (50%)], the middle cerebral artery [n = 2 (4.5%)], the anterior cerebral artery-anterior communicating artery [n = 10 (22.7%)], the basilar artery [n = 9 (20.5%)], and the vertebral artery [n = 1 (2.3%)]. MDS tungsten and platinum miscospirals (Balt, France) were employed for aneurysmal occlusion. Twenty seven (61.4%) aneurysms were totally and subtotally closed by means of microspirals. Partial occlusion of the aneurysmal cavity was achieved in 12 (27.2%) cases. There were poor results associated with spiral migration into the carrying vessel in 5 patients: an increase in aneurysmal volumes occurred in 3 patients and in 2 patients with partially occluded giant aneurysms within up to a year. Three patients died. Angiographical control was exercised in 12 patients at months 6 to 18. The analysis of long-term results indicated that the aneurysms initially totally closed failed to be recanalized later on (8 patients). With subtotal or partial occlusion, there was a change in the position of spiral coils in the aneurysmal cavity, namely, their displacement to the bottom and an increase in the dimension of a functioning aneurysmal part (2 patients). The use of microspirals for occlusion of cerebrovascular aneurysms is a low-traumatic and effective treatment. The best results were obtained with the occlusion of small and large aneurysms with their well-defined neck.
Serbinenko
F A
FA
Iakovlev
S B
SB
Bocharov
A V
AV
D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D005548:Foreign-Body Migration / Q000209:etiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D010984:Platinum; D019736:Prostheses and Implants / Q000009:adverse effects; D013345:Subarachnoid Hemorrhage / Q000209:etiology / Q000601:surgery; D013525:Surgical Instruments; D016896:Treatment Outcome; D014414:Tungsten; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods*
D010984:Platinum; D014414:Tungsten