title: Results of endovascular treatment of aneurysms depending on their size, volume and coil packing density.
abstract: OBJECTIVE
  In contrast to neurosurgery, which is more efficient, endovascular treatment (EVT) is less invasive. The main purpose of EVT is complete occlusion of the aneurysm and protection from subarachnoid haemorrhage. Accurate measurements of the aneurysm (size, volume) obtained using a 3D digital subtraction angiography (DSA) workstation can assist in the proper assessment of coil packing density (CPD), which affects possible distant recanalization. The main disadvantage of endovascular treatment of intracranial aneurysms compared to neurosurgery is the high recurrence rate. We evaluated the results of endovascular treatment of aneurysms depending on their size, volume and coil packing density.
  
  
  METHODS
  Thirty-five patients with intracranial aneurysms underwent endovascular embolization with bare platinum coils. Three-dimensional DSA was used to evaluate aneurysms' morphology. Eighteen patients underwent 3D DSA follow-up 6-45 months after treatment. Initial and follow-up results of embolization were assessed with the Raymond-Montreal scale. The impact of aneurysms' morphology, volume and initial CPD on endovascular treatment was evaluated.
  
  
  RESULTS
  Among 35 patients, complete initial embolization was achieved in 74%. Mean initial aneurysm volume in 3D DSA was 0.517 mL and decreased significantly after embolization. Initial CPD varied from 74% to 2% depending on aneurysm diameter (12.1% for aneurysms ≥ 10 mm, 22.5% for aneurysms < 10 mm). Results of embolization on the Raymond-Montreal scale significantly depended on aneurysms' CPD. Aneurysms' recanalization rate on 3D DSA follow-up was 36%, with complete recanalization in 3.3%.
  
  
  CONCLUSIONS
  We can achieve a better outcome if size and volume of the aneurysm sac is smaller and if CPD is higher.
authors.affiliation: Dr Damian Ptak, Zakład Radiodiagnostyki i Radiologii Zabiegowej, SP CSK SUM Katowice, ul. Medyków 14, 40-752 Katowice, Polska, e-mail: ptak.damian@wp.pl.
authors.forename: D
authors.initials: D
authors.lastname: Knap
authors.forename: K
authors.initials: K
authors.lastname: Gruszczyńska
authors.forename: R
authors.initials: R
authors.lastname: Partyka
authors.forename: D
authors.initials: D
authors.lastname: Ptak
authors.forename: M
authors.initials: M
authors.lastname: Korzekwa
authors.forename: M
authors.initials: M
authors.lastname: Zbroszczyk
authors.forename: J
authors.initials: J
authors.lastname: Baron
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D020099:Coated Materials, Biocompatible / Q000378:metabolism*; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D016896:Treatment Outcome
chemical_list: D020099:Coated Materials, Biocompatible