Intravascular Treatment for Cerebral Aneurysms

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 145-148
Author(s):  
M. Negoro ◽  
T. Okamoto ◽  
S. Miyachi ◽  
I. Takahashi ◽  
K. Fukui ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Internal Carotid ◽  
Cerebral Aneurysms ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Occlusion Rate ◽  
Treatment For Cerebral Aneurysms ◽  
Intravascular Treatment ◽  
Wide Neck

We have treated 142 aneurysms with intrasaccular or parent artery occlusions. Selective intrasaccular occlusions were attempted on 109 cases. Total or subtotal saccular occlusion was achieved in 93 of 96 cases. Intrasaccular occlusion could not be achieved in 13 cases because of various reasons such as wide neck, branching from aneurysmal dome, difficult to catheterize, and aneurysm too small. Parent artery occlusion was attempted on 33 cases. Twenty-five patients had giant aneurysms of the internal carotid artery (ICA) at the cavernous portion. The rest of this group had dissecting or fusiform aneurysms of the vertebral artery. Parent artery occlusion was achieved in 30 cases with six ischemic symptoms. High percentage of occlusion rate and low morbidity and mortality for metallic coil embolization prove the efficacy of this endovascular treatment.

Balloon Migration into a Giant Carotid Aneurysm after Parent Artery Occlusion Using Detachable Balloons

1998 ◽  
Vol 4 (4) ◽  
pp. 323-328 ◽  
Author(s):  
A. Uchino ◽  
P.K. Maurer ◽  
H.S. Brara ◽  
Y. Numaguchi
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Parent Artery Occlusion ◽  
Occlusion Technique ◽  
Large Aneurysm ◽  
The Right

We treated a 70-year-old man with a giant paraophthalmic region aneurysm of the right internal carotid artery using the parent artery occlusion technique with three detachable balloons. Initially, the patient did well, but migration of the distal balloon into the aneurysm was detected seven months later. This report suggests that initial parent artery occlusion using balloons will not always induce permanent thrombosis of a large aneurysm, because the occlusion and thrombosis is strictly dependant on the position of the balloons that are used, and adjunct use of coils may be indicated.

scholarly journals Analysis of Supplemental Surgical or Endovascular Treatment for Cerebral Aneurysms in the Endovascular Performed Cases

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 73-76
Author(s):  
K. Fukui ◽  
M. Watanabe ◽  
N. Inoue ◽  
K. Wakabayashi ◽  
T. Kato ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Bypass Surgery ◽  
Cerebral Aneurysms ◽  
Artery Occlusion ◽  
Parent Artery ◽  
Modified Rankin Scale ◽  
Surgical Clipping ◽  
Parent Artery Occlusion ◽  
Treatment For Cerebral Aneurysms ◽  
Surgical Treatments

In the 150 endovascular performed cases from May 1997 to Dec 2004, supplemental combination of endovascular and surgical treatments were performed in 46 cases. Characteristics of the treatments were combination for multiple aneurysms, surgical clipping for failed endovascular attempt, embolization for recurrence after clipping, bypass surgery before endovascular parent artery occlusion, surgery for recurrent aneurysms after embolization, and embolization for failed surgical attempt. Sixty seven percent of ruptured and 87% of unruptured cases showed satisfactory clinical outcome (modified Rankin scale = 0 to 2). Supplemental combination of each treatment will support the disadvantage of another treatment, and which improve the clinical outcome of cerebral aneurysm.

Results and Problems on Direct Embolization of Cerebral Aneurysms Using Interlocking Detachable Coils

1997 ◽  
Vol 3 (2_suppl) ◽  
pp. 162-164
Author(s):  
S. Yoshimura ◽  
T. Ueda ◽  
Y. Kaku ◽  
Y. Nishimura ◽  
T. Andoh ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Clinical Results ◽  
Artery Occlusion ◽  
Neurological Deficits ◽  
Parent Artery ◽  
Neck Size ◽  
New Device ◽  
Parent Artery Occlusion ◽  
Detachable Coils ◽  
Wide Neck

The clinical results of direct embolization of cerebral aneurysms using interlocking detachable coils (IDCs) were analysed. In 27 patients who underwent direct embolization of the aneurysm, 19 patients (70%) were treated uneventfully. In the other 8 patients, symptomatic or asymptomatic complications occurred; parent artery occlusion in 3 patients, rupture of the aneurysm in 2 patients, distal embolism in 2 patients, and neurological deterioration due to enlargement of the aneurysm after embolization in 1 patient. In 5 of 8 patients in whom complications occurred, neurological deficits disappeared after additional embolizations or thrombolysis therapies. Permanent deficits were observed in 3 of all patients (11%). These deficits were caused by the parent artery occlusion due to protrusion of the detached coil in wide neck aneurysms. These results suggest that indication of direct embolization of the cerebral aneurysm should be decided according to neck size. Balloon-assisted coil placement in wide-necked aneurysms was useful but unable to prevent protrusion or migration of the coils after balloon withdrawal. Development of a new device, such as a stent for intracranial use, may make it possible.

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