title: Endovascular treatment of pediatric intracranial aneurysms: a retrospective study of 35 aneurysms.
abstract: BACKGROUND
  Pediatric intracranial aneurysms are rare and not well characterized in comparison with those in adults.
  
  
  OBJECTIVE
  To analyze our institution's longitudinal experience of endovascular treatment for pediatric aneurysms to better understand this rare condition.
  
  
  METHODS
  A retrospective record review was performed of patients aged <20 years treated with endovascular methods for intracranial aneurysms between 1995 and 2012. There were 31 patients (average 14.4±4.2 years; 20 male, 11 female) with 35 intracranial aneurysms.
  
  
  RESULTS
  The rate of subarachnoid hemorrhage as the initial presentation was 48% and the rates of multiple and giant aneurysms were 13% and 31%, respectively; 28.5% of the cases were posterior circulation aneurysms. Fifteen saccular aneurysms occurred in 14 patients and 17 fusiform aneurysms were noted in 14 patients. Two infectious aneurysms were diagnosed in two patients and one traumatic aneurysm occurred in another patient. Thirty-four aneurysms were treated endovascularly and one had thrombosed spontaneously on a follow-up angiogram. Of the 15 saccular aneurysms, 11 were treated with conventional coiling, one was treated with stent-assisted coiling, one was treated with a flow-diverting stent and two were treated with parent vessel occlusion (PVO). Of the 17 fusiform aneurysms, 15 were treated with PVO with or without prior bypass surgery and one was treated with a flow-diverting stent. The rate of permanent complications and a favorable outcome were 2.9% and 87%, respectively.
  
  
  CONCLUSIONS
  Endovascular treatment of pediatric aneurysms is technically feasible with an acceptable complication rate despite the high incidence of fusiform aneurysms.
authors.affiliation: Division of Interventional Neuroradiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Takemoto
authors.affiliation: Division of Interventional Neuroradiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tateshima
authors.affiliation: Division of Interventional Neuroradiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Golshan
authors.affiliation: Division of Interventional Neuroradiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
authors.forename: Nestor
authors.initials: N
authors.lastname: Gonzalez
authors.affiliation: Division of Interventional Neuroradiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
authors.forename: Reza
authors.initials: R
authors.lastname: Jahan
authors.affiliation: Division of Interventional Neuroradiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
authors.forename: Gary
authors.initials: G
authors.lastname: Duckwiler
authors.affiliation: Division of Interventional Neuroradiology, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Vinuela
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: Aneurysm; Coil; Flow Diverter; Intervention; Pediatrics