scholarly journals Comparing the frequency of symptomatic cerebral vasospasm and vasospasm-related ischemia in Fisher 3 grade ruptured anterior communicating artery aneurysms treated via microsurgical clipping or endovascular coiling

2022 ◽  
Vol 27 ◽  
pp. 101379
Author(s):  
Eyüp Baykara ◽  
Abdullah Topçu
Keyword(s):  
Cerebral Vasospasm ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Microsurgical Clipping ◽  
Anterior Communicating Artery Aneurysms

Cognitive Impairments and Associated Factors After Ruptured Anterior Communicating Artery Aneurysm Treatment in Low-Grade Patients <60 Years: A Multicenter Retrospective Study

2020 ◽  
Author(s):  
Ning Ma ◽  
Xin Feng ◽  
Zhongxue Wu ◽  
Daming Wang ◽  
Aihua Liu
Keyword(s):  
Regression Analysis ◽  
Cognitive Impairment ◽  
Cox Regression ◽  
Cognitive Impairments ◽  
Young Patients ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Cox Regression Analysis ◽  
Microsurgical Clipping

Abstract Background Aneurysmal subarachnoid hemorrhage (SAH) is a kind of destructive cerebrovascular disease which could affect people's cognition, even the life expectancy. People with SAH are considered in a fatal situation, especially in the young population. This study aimed to investigate cognitive impairment and related factors in young patients with ruptured anterior communicating artery (ACoA) aneurysms.Methods We conducted a multicentre retrospective follow-up study at three hospitals in China. The young patients (18-50 years) who underwent ruptured ACoA aneurysm treatment by microsurgical clipping or endovascular coiling at three academic institutions in China from January 2015 to November 2017 were recruited. Patient cognition and life quality were assessed by using modified Telephone Interview for Cognitive Status (TICS-m), the modified Rankin Scale (mRS), and the instrumental activities of daily living (IADL) scale 2. Multiple cox-regression analysis was used to identify variables independently associated with cognitive impairment.Results Of the total of 59 patients, 54 (91.5%) achieved good clinical outcomes (mRS score 0-2) and 51 (86.4%) had excellent quality of life (IADL score 8). Ten (16.9%) patients showed cognitive impairments (TICS-m<27). The multivariate COX regression analysis showed that mRS scores of 3-5 at discharge, female sex, and aneurysm size <5 mm was independently associated with cognitive impairment. TICS-m scores at the latest follow-up were similar after open surgery and coiling. Conclusion In this relatively young sample that excluded patients with very poor-grade SAH or serious complications, microsurgical clipping led to better clinical outcomes than endovascular coiling, while cognitive outcomes were similar across treatment modalities. These results are not completely consistent with previous studies, and should therefore be considered in the clinical practice as well as further investigated in larger patient samples.

Quality of life and brain damage after microsurgical clip occlusion or endovascular coil embolization for ruptured anterior communicating artery aneurysms: neuropsychological assessment

2009 ◽  
Vol 110 (1) ◽  
pp. 19-29 ◽  
Author(s):  
François Proust ◽  
Olivier Martinaud ◽  
Emmanuel Gérardin ◽  
Stéphane Derrey ◽  
Sophie Levèque ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Executive Functions ◽  
Verbal Memory ◽  
Coil Embolization ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Microsurgical Clipping ◽  
Endovascular Coil Embolization ◽  
Clip Occlusion

Object For anterior communicating artery (ACoA) aneurysms, endovascular coil embolization constitutes a safe alternative therapeutic procedure to microsurgical clip occlusion. The authors' aim in this study was to evaluate the quality of life (QOL), cognitive function, and brain structure damage after the treatment of ruptured ACoA aneurysms in a group of patients who underwent microsurgical clipping (36 patients) compared with a reference group who underwent endovascular coiling (14 patients). Methods At 14 months posttreatment all patients underwent evaluations by independent observers. These observers evaluated global efficacy, executive functions using a frontal assessment battery of tests (Trail making test, Stroop tasks, dual task of Baddeley, verbal fluency, and Wisconsin Card Sorting test), behavior dysexecutive syndrome (the Inventaire du Syndrome Dysexécutif Comportemental questionnaire [ISDC]), and QOL by using the Reintegration To Normal Living Index. Brain damage was analyzed using MR imaging. Results In the microsurgical clipping and endovascular coiling groups, the distribution on the modified Rankin Scale (p = 0.19) and mean QOL score (85.4 vs 83.4, respectively) were similar. Moreover, the proportion of executive dysfunctions (19.4 vs 28.6%, respectively) and the mean score on the ISDC questionnaire (8.9 vs 8.5, respectively) were not significant, but verbal memory was more altered in the microsurgical clipping group (p = 0.055). Magnetic resonance imaging revealed that the incidence of local encephalomalacia and the median number of lesions per patient increased significantly in the microsurgical clipping group (p = 0.003). Conclusions In the 2 groups, no significant difference was observed regarding QOL, executive functions, and behavior. Despite the significant decrease in verbal memory after microsurgical clipping, the interdisciplinary approach remains a safe and useful strategy.

Definitive Treatment With Microsurgical Clipping After Recurrence and Rerupture of Coiled Anterior Cerebral Artery Aneurysms

2020 ◽  
Vol 19 (4) ◽  
pp. 393-402
Author(s):  
Daniel M S Raper ◽  
Caleb Rutledge ◽  
Ethan A Winkler ◽  
Adib A Abla
Keyword(s):  
Cerebral Artery ◽  
Intracranial Aneurysms ◽  
Anterior Cerebral Artery ◽  
Significant Risk ◽  
Subsequent Treatment ◽  
Definitive Treatment ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Recent Experience ◽  
Microsurgical Clipping

Abstract BACKGROUND The extent of obliteration of ruptured intracranial aneurysms treated with coil embolization has been correlated with the risk of rerupture. However, many practitioners consider that a small neck remnant is unlikely to result in significant risk after coiling. OBJECTIVE To report our recent experience with ruptured anterior cerebral artery aneurysms treated with endovascular coiling, which recurred or reruptured, requiring microsurgical clipping for subsequent treatment. METHODS Retrospective review of patients with intracranial aneurysms treated at our institution since August 2018. Patient and aneurysm characteristics, initial and subsequent treatment approaches, and outcomes were reviewed. RESULTS Six patients were included. Out of those 6 patients, 5 patients had anterior communicating artery aneurysms, and 1 patient had a pericallosal aneurysm. All initially presented with subarachnoid hemorrhage (SAH) and were treated with coiling. Recurrence occurred at a median of 7.5 mo. In 2 cases, retreatment was initially performed with repeat endovascular coiling, but further recurrence was observed. Rerupture from the residual or recurrent aneurysm occurred in 3 cases. In 2 cases, the aneurysm dome recurred; in 1 case, rerupture occurred from the neck. All 6 patients underwent treatment with microsurgical clipping. Follow-up catheter angiography demonstrated a complete occlusion of the aneurysm in all cases with the preservation of the parent vessel. CONCLUSION Anterior cerebral artery aneurysms may recur after endovascular treatment, and even small neck remnants present a risk of rerupture after an initial SAH. Complete treatment requires a complete exclusion of the aneurysm from the circulation. Even in cases that have been previously coiled, microsurgical clipping can represent a safe and effective treatment option.

Ruptured anterior communicating artery aneurysms treated by coiling technique: characteristics, outcomes and prognosises

2020 ◽  
Author(s):  
Tuan Minh Nguyen Tran
Keyword(s):  
Artery Aneurysm ◽  
Sudden Onset ◽  
Endovascular Coiling ◽  
Hospital Death ◽  
Anterior Communicating Artery ◽  
P Value ◽  
Anterior Communicating Artery Aneurysms ◽  
Complete Obliteration ◽  
Stroke Center ◽  
A Prospective Study

RUPTURED ANTERIOR COMMUNICATING ARTERY ANEURYSMS TREATED BY COILING TECHNIQUE: CHARACTERISTICS, OUTCOMES AND PROGNOSISES Abstract A prospective study of 31 patients with ruptured anterior communicating artery aneurysm (ACoA) treated by endovascular coiling was carried out at Stroke center - Hue Central Hospital, from September 2018 – February 2020. The results obtained were: Male:female ratio = 2.1: 1, age 54.2 ± 15.3 (21-85); clinically sudden onset 100%, headache 87.1%, vomiting 45.2%, cranial nerve palsy 12.9%, hemiparesis 29%, aphasia 11%; Hunt-Hess 1-3 61.3%, Fisher 1-3 35.2%, Glasgow coma score ≤8 19.4%; aneurysm size 5.6 ± 2.0 mm (2.5-10 mm), complete obliteration 81%; delayed ischemia 19.4%, ventricular dilation 45.2%, in-hospital recurrent hemorrhage 0%, modified Rankin scale (mRS) 0-2 at discharge 51.6%; mRS 0-2 after 3 months 54.8%, in-hospital death 0%, death within 3 months 22.6%. There was a moderate correlation between Hunt-Hess, Glasgow score at admission and mortality within 3 months; there was a statistically significant relationship between Glasgow coma scale-based groups and mortality (OR 0.34; 95% CI: 0.12 - 0.99; p = 0.047, p-value 77.4%).

scholarly journals Letter: Neuropsychologically Guided Prediction of Vasospasm After Endovascular Coiling for Anterior Communicating Artery Aneurysms: A Theory-Based Hypothesis

Neurosurgery ◽  
2020 ◽  
Vol 87 (2) ◽  
pp. E269-E270
Author(s):  
Panayiotis Patrikelis ◽  
Themistoklis Papasilekas ◽  
Stefanos Korfias ◽  
Damianos E Sakas ◽  
Stylianos Gatzonis
Keyword(s):  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Anterior Communicating Artery Aneurysms

Endovascular Coiling versus Surgical Clipping of Very Small Ruptured Anterior Communicating Artery Aneurysms

2019 ◽  
Vol 126 ◽  
pp. e1246-e1250 ◽  
Author(s):  
Bing Zhao ◽  
Haixia Xing ◽  
Lianghao Fan ◽  
Xianxi Tan ◽  
Ming Zhong ◽  
...  
Keyword(s):  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Surgical Clipping ◽  
Anterior Communicating Artery Aneurysms

scholarly journals A Novel Treatment of Distal Cerebral Vasospasm

2009 ◽  
Vol 15 (4) ◽  
pp. 417-420 ◽  
Author(s):  
I. Alnaami ◽  
M. Saqqur ◽  
M. Chow
Keyword(s):  
Medical Treatment ◽  
Cerebral Vasospasm ◽  
Balloon Angioplasty ◽  
Artery Aneurysm ◽  
Endovascular Coiling ◽  
Anterior Communicating Artery ◽  
Excellent Outcome ◽  
Clinical Recovery ◽  
Anterior Communicating Artery Aneurysm ◽  
Novel Treatment

A 22-year-old woman had an aneurysmal SAH due to a ruptured anterior communicating artery aneurysm and was treated successfully with endovascular coiling. The patient subsequently developed severe clinical and angiographically distal vasospasm. After failure of both medical treatment and proximal balloon angioplasty, the NeuroFlo™ device was tried and the patient showed substantial clinical recovery. We demonstrated an excellent outcome using a novel treatment for distal cerebral vasospasm with the NeuroFlo™ device.

Sign in / Sign up

Export Citation Format

Share Document