Clinical and anatomic outcomes after endovascular coiling of middle cerebral artery aneurysms: report on 30 treated aneurysms and review of the literature.
BACKGROUND
Endovascular treatment of middle cerebral artery (MCA) aneurysms has not been extensively studied. We report our experience on a select group of patients that underwent coil embolization of an MCA bifurcation aneurysm.


METHODS
From August 1999 to January 2005, 29 patients harboring 30 MCA aneurysms were treated with coil embolization. These patients were felt to have favorable characteristics for endovascular therapy including absence of thrombus in the aneurysm, absence of an efferent artery off of the aneurysm, and ability to reconstruct the wide neck with stent reconstruction. We retrospectively reviewed their records and angiographic images to evaluate for technical result and complications.


RESULTS
The mean age of our cohort was 59 +/- 13 years with 19 patients presenting with a ruptured aneurysm. Complete obliteration was achieved in 24 (80%) of 30 of aneurysms on postprocedural angiography and no patient showed aneurysm regrowth at 6-month follow-up. Twenty-seven (93%) of 29 patients had no change in baseline neurological function post-embolization. There were two procedural-related complications: one intraprocedural rupture of an aneurysm and one thromboembolic stroke in the ipsilateral MCA territory.


CONCLUSIONS
Coil embolization of MCA bifurcation aneurysms has a high rate of complete obliteration with acceptable morbidity in our selected group of patients.
Horowitz
Michael
M
Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. horowitzmb@upmc.edu
Gupta
Rishi
R
Gologorsky
Yakov
Y
Jovin
Tudor
T
Genevro
Julie
J
Levy
Elad
E
Kassam
Amin
A
D000368:Aged; D017130:Angioplasty; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome