title: Feasibility, procedural morbidity and mortality, and long-term follow-up of endovascular treatment of 321 unruptured aneurysms.
abstract: OBJECTIVE
  The purpose of our study was to evaluate the technical feasibility, morbidity and mortality, and durability of occlusion of unruptured aneurysms treated with Guglielmi detachable coils (GDCs) with a long-term follow-up.
  
  
  METHODS
  Between January 1998 and January 2005, we treated 321 unruptured aneurysms with GDCs in 5 neuroradiologic institutions. During this period, 63% of unruptured aneurysms were treated by endovascular technique. Procedural feasibility, technical complications, morbidity and mortality, and acute and long-term angiographic occlusion were assessed.
  
  
  RESULTS
  Overall technical feasibility of coiling treatment was 94%; 302 aneurysms were treated by endovascular technique. At the end of the initial procedure, acute occlusion was classified as complete in 207 cases (70%), subtotal in 84 cases (26.1%), and incomplete in 11 cases (3.9%). Ischemic complications were observed in 28 patients (9%); 8 patients (2.6%) had perforation of their aneurysms. Treatment-related morbidity was 14.4%, and morbidity with clinical complications was evaluated at 7.7% (n = 23 patients). Five patients (1.7%) died as a result of aneurysm perforation. Final follow-up angiograms, after 9 secondary treatments, demonstrated complete occlusion in 193 patients (69.5%), subtotal in 80 aneurysms (28.5%), and incomplete occlusion in 5 (1.8%). Nineteen patients were lost to follow-up (6.3%).
  
  
  CONCLUSIONS
  Endovascular coiling with detachable coils is an attractive option for treatment of unruptured aneurysms. This method of treatment is safe with a low rate of complications. Prospective studies with longer follow-up periods are needed to assess the long-term durability of occlusion in unruptured aneurysms.
authors.affiliation: Department of Neuroradiology Hospitalier Universitaire Maison Blanche, Reims, France. sgallas@chu-reims.fr
authors.forename: S
authors.initials: S
authors.lastname: Gallas
authors.forename: J
authors.initials: J
authors.lastname: Drouineau
authors.forename: J
authors.initials: J
authors.lastname: Gabrillargues
authors.forename: A
authors.initials: A
authors.lastname: Pasco
authors.forename: C
authors.initials: C
authors.lastname: Cognard
authors.forename: L
authors.initials: L
authors.lastname: Pierot
authors.forename: D
authors.initials: D
authors.lastname: Herbreteau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D004621:Embolization, Therapeutic / Q000295:instrumentation* / Q000401:mortality*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome