title: Contrast stasis in large and giant internal carotid artery aneurysms as a good prognostic factor for endovascular coil embolization: retrospective study.
abstract: OBJECTIVE
  Before treatment for large and giant aneurysms, we need some of the predictors to prognose a good result. In this retrospective study, we attempted to determine criteria such as angiographic signs to identify good candidates for effective endovascular surgery.
  
  
  METHODS
  This study involved 45 patients with large or giant aneurysms treated by endovascular embolization. For angiographic study, we delivered a bolus injection of contrast medium. All aneurysms were confirmed angiographically and the morphology was defined in detail before  endovascular embolization. We divided the patients into two groups based on angiographic findings. Group A (n=16) manifested stasis of the contrast medium in the aneurysm on venous phase. Group B (n=29) exhibited other findings. We retrospectively evaluated  the relationship between stasis of the contrast medium in the aneurysm and results of endovascular embolization.
  
  
  CONCLUSIONS
  There was no significant difference between the two groups with respect to the size of the aneurysm. However, the neck/dome ratio (P=0·04)  and size of the neck (P=0·003) were significantly different between groups A and B. The morphological outcome was better in group A than group B (P=0·03). We demonstrate that contrast stasis is a good predictor of outcome in patients with large  or giant aneurysms to consider the endovascular embolization. Hemodynamic studies on large patient populations may reveal other factors predictive of a good treatment outcome.
authors: Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Japan. ssachio@med.kitasato-u.ac.jp
authors: Sachio
authors: S
authors: Suzuki
authors: Akira
authors: A
authors: Kurata
authors: Masaru
authors: M
authors: Yamada
authors: Kazuhisa
authors: K
authors: Iwamoto
authors: Kuniaki
authors: K
authors: Nakahara
authors: Jun
authors: J
authors: Niki
authors: Kimitoshi
authors: K
authors: Sato
authors: Kiyotaka
authors: K
authors: Fujii
authors: Shinichi
authors: S
authors: Kan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods; D003287:Contrast Media / Q000378:metabolism*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media