Long-Term Angiographic Recurrences After Selective Endovascular Treatment of Aneurysms With Detachable Coils

AbstractEndovascular therapy as any other specialty has continuously been developed since 1904, but acceptability among neurosurgeons remains low despite being other subspecialties and techniques, like endoscope and for that matter microscope also, being adopted very rapidly. From injecting particles for vascular lesions to balloons for fistulas and arteriovenous malformations and embolizing agents to detachable coils for aneurysm coiling, it has come a long way. Old generations of neurosurgeons used to perform carotid puncture for diagnosing mass lesions, but once CT/MRI came in to the picture, this procedure was stopped and handed over to radiologists. A debate continues among neurosurgeons about the feasibility of aneurysm coiling since international subarachnoid aneurysm trial (ISAT) and doubts about the long-term efficacy of this novel treatment cost a subspecialty. With the recent addition of endovascular treatment of stroke and long-term efficacy of endovascular treatment of aneurysm, there is a lot of debate among clinicians and nonclinicians about who will be the true heir of this sub specialty.

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Endovascular Treatment of Unruptured Intracranial Aneurysms With Guglielmi Detachable Coils: Short- and Long-Term Results of a Single-Centre Series

Yearbook of Diagnostic Radiology ◽

10.1016/s0098-1672(08)79047-7 ◽

2008 ◽

Vol 2008 ◽

pp. 274-275

Author(s):

A.G. Osborn

Keyword(s):

Endovascular Treatment ◽

Intracranial Aneurysms ◽

Long Term Results ◽

Guglielmi Detachable Coils ◽

Single Centre ◽

Unruptured Intracranial Aneurysms ◽

Detachable Coils ◽

Short And Long Term

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Endovascular Treatment of Ruptured Intracranial Aneurysms with Detachable Coils: Long-term Clinical and Serial Angiographic Results

Radiology ◽

10.1148/radiol.2273020656 ◽

2003 ◽

Vol 227 (3) ◽

pp. 720-724 ◽

Cited By ~ 140

Author(s):

Menno Sluzewski ◽

Willem Jan van Rooij ◽

Gabriël J. E. Rinkel ◽

Douwe Wijnalda

Keyword(s):

Endovascular Treatment ◽

Intracranial Aneurysms ◽

Detachable Coils ◽

Ruptured Intracranial Aneurysms

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Spontaneous Thrombosis of Significant Aneurysm Recanalization in the Long Term Follow-up of Coiled Aneurysms: Observation in Two Cases

Interventional Neuroradiology ◽

10.1177/159101990501100208 ◽

2005 ◽

Vol 11 (2) ◽

pp. 167-171 ◽

Cited By ~ 2

Author(s):

I. Saatchi ◽

U. Kerimoglu ◽

C. Barbaros ◽

T. Haziroln ◽

S. Cekirge

Keyword(s):

Endovascular Treatment ◽

Treatment Strategies ◽

Cerebral Aneurysms ◽

Spontaneous Thrombosis ◽

Long Term Follow Up ◽

Detachable Coils ◽

One Year ◽

Control Angiography

Endovascular treatment of cerebral aneurysms with detachable coils has now been proved to be a superior alternative to open microsurgery in terms of survival free of disability at one year according to the recently published large randomized International Subaracnoid Aneurysm Trial (ISAT). However, aneurysm recanalization secondary to coil compaction is still the main problem of this technique observed in the follow-up period but treatment strategies for these regrowths are not yet well established. We present two interesting cases in which we observed a significant aneurysm recanalization at six month control angiography that was found to be spontaneously thrombosed in the late follow-up angiograms at the second and fifth years consecutively.

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Anticoagulation in addition to dual antiplatelet therapy has no impact on long-term follow-up after endovascular treatment of (sub)acute lower limb ischemia

VASA ◽

10.1024/0301-1526/a000786 ◽

2019 ◽

Vol 48 (4) ◽

pp. 321-329

Author(s):

Mariya Kronlage ◽

Erwin Blessing ◽

Oliver J. Müller ◽

Britta Heilmeier ◽

Hugo A. Katus ◽

...

Keyword(s):

Endovascular Treatment ◽

Antiplatelet Therapy ◽

Dual Antiplatelet Therapy ◽

Limb Ischemia ◽

Bleeding Complications ◽

Severe Bleeding ◽

Short Term ◽

Long Term Follow Up

Summary. Background: To assess the impact of short- vs. long-term anticoagulation in addition to standard dual antiplatelet therapy (DAPT) upon endovascular treatment of (sub)acute thrombembolic occlusions of the lower extremity. Patient and methods: Retrospective analysis was conducted on 202 patients with a thrombembolic occlusion of lower extremities, followed by crirical limb ischemia that received endovascular treatment including thrombolysis, mechanical thrombectomy, or a combination of both between 2006 and 2015 at a single center. Following antithrombotic regimes were compared: 1) dual antiplatelet therapy, DAPT for 4 weeks (aspirin 100 mg/d and clopidogrel 75 mg/d) upon intervention, followed by a lifelong single antiplatelet therapy; 2) DAPT plus short term anticoagulation for 4 weeks, followed by a lifelong single antiplatelet therapy; 3) DAPT plus long term anticoagulation for > 4 weeks, followed by a lifelong anticoagulation. Results: Endovascular treatment was associated with high immediate revascularization (> 98 %), as well as overall and amputation-free survival rates (> 85 %), independent from the chosen anticoagulation regime in a two-year follow up, p > 0.05. Anticoagulation in addition to standard antiplatelet therapy had no significant effect on patency or freedom from target lesion revascularization (TLR) 24 months upon index procedure for both thrombotic and embolic occlusions. Severe bleeding complications occurred more often in the long-term anticoagulation group (9.3 % vs. 5.6 % (short-term group) and 6.5 % (DAPT group), p > 0.05). Conclusions: Our observational study demonstrates that the choice of an antithrombotic regime had no impact on the long-term follow-up after endovascular treatment of acute thrombembolic limb ischemia whereas prolonged anticoagulation was associated with a nominal increase in severe bleeding complications.

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Stents for the Treatment of Aortic Aneurysms

Thrombosis and Haemostasis ◽

10.1055/s-0037-1615578 ◽

1999 ◽

Vol 82 (S 01) ◽

pp. 171-175 ◽

Cited By ~ 1

Author(s):

D. Ebert ◽

M. Langer ◽

P. Uhrmeister

Keyword(s):

Endovascular Treatment ◽

Endovascular Repair ◽

Abdominal Aortic Aneurysms ◽

Aortic Aneurysms ◽

Imaging Modalities ◽

Exclusion Criteria ◽

Multicenter Studies ◽

Abdominal Aortic ◽

First Results

SummaryThe endovascular treatment of abdominal aortic aneurysms has generated a great deal of interest since the early 1990s, and many different devices are currently available. The procedure of endovascular repair has been evaluated in many institutions and the different devices are compared. The first results were encouraging, but complications like endoleak, dislocation or thrombosis of the graft occurred. By the available devices the stent application is only promising, if the known exclusion criteria are strictly respected. Therefore a careful preinterventional assessment of the patient by different imaging modalities is necessary. As the available results up to now are preliminary and the durability of the devices has to be controlled, multicenter studies are required to improve the devices and observe their long- term success in the exclusion of abdominal aortic aneurysms.

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