scholarly journals Scoring of Growth of Unruptured Intracranial Aneurysms

2020 ◽  
Vol 9 (10) ◽  
pp. 3339
Author(s):  
Seppo Juvela
Keyword(s):  
Intracranial Aneurysms ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Receiver Operating Curve ◽  
Female Sex ◽  
Unruptured Intracranial Aneurysms ◽  
Long Term Follow Up ◽  
Better Than

The purpose was to obtain a reliable scoring for growth of unruptured intracranial aneurysms (UIAs) in a long-term follow-up study from variables known at baseline and to compare it with the ELAPSS (Earlier subarachnoid hemorrhage, Location of the aneurysm, Age > 60 years, Population, Size of the aneurysm, and Shape of the aneurysm) score obtained from an individual-based meta-analysis. The series consists of 87 patients with 111 UIAs and 1669 person-years of follow-up between aneurysm size measurements (median follow-up time per patient 21.7, range 1.2 to 51.0 years). These were initially diagnosed between 1956 and 1978, when UIAs were not treated in our country. ELAPSS scores at baseline did not differ between those with and those without aneurysm growth. The area under the curve (AUC) for the receiver operating curve (ROC) of the ELAPSS score for predicting long-term growth was fail (0.474, 95% CI 0.345–0.603), and the optimal cut-off point was obtained at ≥7 vs. <7 points for sensitivity (0.829) and specificity (0.217). In the present series UIA growth was best predicted by female sex (4 points), smoking at baseline (3 points), and age <40 years (2 points). The AUC for the ROC of the new scoring was fair (0.662, 95% CI 0.546–0.779), which was significantly better than that of ELAPSS score (p < 0.05). The optimal cut-off point was obtained at ≥4 vs. <4 points for sensitivity (0.971) and specificity (0.304). A new simple scoring consisting of only female sex, cigarette smoking and age <40 years predicted growth of an intracranial aneurysm in long-term follow-up, significantly better than the ELAPSS score.

Long-term follow-up study of unruptured intracranial aneurysms

1997 ◽  
Vol 99 ◽  
pp. S41
Author(s):  
Nobuyuki Yasui ◽  
Akufumi Suzuki ◽  
Hiromi Nishimura ◽  
Kazuo Suzuki ◽  
Takako Abe
Keyword(s):  
Intracranial Aneurysms ◽  
Follow Up Study ◽  
Unruptured Intracranial Aneurysms ◽  
Long Term Follow Up

scholarly journals Long-term outcomes of coil embolization of unruptured intracranial aneurysms

2018 ◽  
Vol 129 (6) ◽  
pp. 1492-1498 ◽  
Author(s):  
Masaomi Koyanagi ◽  
Akira Ishii ◽  
Hirotoshi Imamura ◽  
Tetsu Satow ◽  
Kazumichi Yoshida ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Additional Treatment ◽  
Long Term Outcomes ◽  
Unruptured Intracranial Aneurysms ◽  
Risk Of Rupture ◽  
Long Term Follow Up ◽  
Multiple Stroke

OBJECTIVELong-term follow-up results of the treatment of unruptured intracranial aneurysms (UIAs) by means of coil embolization remain unclear. The aim of this study was to analyze the frequency of rupture, retreatment, stroke, and death in patients with coiled UIAs who were followed for up to 20 years at multiple stroke centers.METHODSThe authors retrospectively analyzed data from cases in which patients underwent coil embolization between 1995 and 2004 at 4 stroke centers. In collecting the late (≥ 1 year) follow-up data, postal questionnaires were used to assess whether patients had experienced rupture or retreatment of a coiled aneurysm or any stroke or had died.RESULTSOverall, 184 patients with 188 UIAs were included. The median follow-up period was 12 years (interquartile range 11–13 years, maximum 20 years). A total of 152 UIAs (81%) were followed for more than 10 years. The incidence of rupture was 2 in 2122 aneurysm-years (annual rupture rate 0.09%). Nine of the 188 patients with coiled UIAs (4.8%) underwent additional treatment. In 5 of these 9 cases, the first retreatment was performed more than 5 years after the initial treatment. Large aneurysms were significantly more likely to require retreatment. Nine strokes occurred over the 2122 aneurysm-years. Seventeen patients died in this cohort.CONCLUSIONSThis study demonstrates a low risk of rupture of coiled UIAs with long-term follow-up periods of up to 20 years. This suggests that coiling of UIAs could prevent rupture for a long period of time. However, large aneurysms might need to be followed for a longer time.

Neurointerventional procedures for unruptured intracranial aneurysms under procedural sedation and local anesthesia: a large-volume, single-center experience

2011 ◽  
Vol 114 (1) ◽  
pp. 120-128 ◽  
Author(s):  
Christopher S. Ogilvy ◽  
Xinyu Yang ◽  
Osama A. Jamil ◽  
Erik F. Hauck ◽  
L. Nelson Hopkins ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Local Anesthesia ◽  
Intracranial Aneurysms ◽  
Conscious Sedation ◽  
Modified Rankin Scale ◽  
Unruptured Intracranial Aneurysms ◽  
Long Term Follow Up ◽  
Neurointerventional Procedures

Object In this paper, the authors' goal was to report the outcome of patients with unruptured intracranial aneurysms undergoing endovascular treatment under conscious sedation (local anesthesia). Methods Between November 5, 2001, and February 5, 2009, the authors treated 340 patients with 358 unruptured aneurysms by using neurointerventional procedures at Millard Fillmore Gates Hospital (Buffalo, New York). The data were retrospectively reviewed for periprocedural safety and long-term follow-up. Results A total of 496 procedures were performed under local anesthesia. Of those, 370 procedures (74.6%) were completed successfully. In 82 procedures (16.5%), an associated medical or technical event occurred. Forty-four procedures (8.9%) were aborted. Rates of overall procedure-related morbidity and mortality were 1.2% (6 of 496) and 0.6% (3 of 496), respectively. The average hospital stay was 1.5 ± 2.5 days. Long-term follow-up was available in 261 (82.1%) of 318 patients whose procedures were performed with local anesthesia. Of those, 246 patients (94.3%) had a good outcome (modified Rankin Scale score ≤ 2), 6 patients (2.3%) had an unfavorable outcome, not related to the procedure, and 9 patients (3.4%) had a poor outcome (modified Rankin Scale score > 2) as a result of the intervention. Conclusions Interventional treatment under conscious sedation (local anesthesia) can be effectively performed in most patients with unruptured intracranial aneurysms and is associated with a short hospital stay and low morbidity and mortality.

Stent-assisted coiling of unruptured intracranial aneurysms: Long-term follow-up in 164 patients with 183 aneurysms

2014 ◽  
Vol 41 (5) ◽  
pp. 322-328 ◽  
Author(s):  
Benjamin Mine ◽  
Ali Aljishi ◽  
Jean-Bernard D’Harcour ◽  
Denis Brisbois ◽  
Laurent Collignon ◽  
...  
Keyword(s):  
Intracranial Aneurysms ◽  
Unruptured Intracranial Aneurysms ◽  
Long Term Follow Up

Long-term Follow-up Study of Unruptured Intracranial Aneurysms

Neurosurgery ◽  
1997 ◽  
Vol 40 (6) ◽  
pp. 1155-1160 ◽  
Author(s):  
Nobuyuki Yasui ◽  
Akifumi Suzuki ◽  
Hiromi Nishimura ◽  
Kazuo Suzuki ◽  
Takako Abe
Keyword(s):  
Intracranial Aneurysms ◽  
Follow Up Study ◽  
Unruptured Intracranial Aneurysms ◽  
Long Term Follow Up

Long-term follow-up of aneurysms treated electively with woven stent-assisted coiling

2017 ◽  
Vol 10 (7) ◽  
pp. 669-674 ◽  
Author(s):  
Nicholas K Cheung ◽  
Albert HY Chiu ◽  
Andrew K Cheung ◽  
Jason D Wenderoth
Keyword(s):  
Intracranial Aneurysms ◽  
Long Term Results ◽  
Thromboembolic Events ◽  
Short Term ◽  
Total Occlusion ◽  
Neurological Outcomes ◽  
Long Term Follow Up ◽  
Better Than

BackgroundPreliminary short-term results for stent-assisted coil embolization (SACE) using woven/braided stents have been promising. However, evidence supporting mid- to long-term efficacy and durability is lacking.ObjectiveTo report the long-term results for the durability of elective intracranial aneurysms treated with woven stents.Materials and methodsBetween May 2012 and May 2015, 98 consecutive patients with 103 aneurysms underwent elective woven SACE across three Australian neurovascular centres. All patients had immediate, 6- and 18-month clinical and radiological follow-up. Radiological assessment was performed with modified Raymond–Roy occlusion scores based on angiography results, while clinical assessment was based on the modified Rankin Scale.ResultsSix-month follow-up was available in 100 aneurysms, and an 18-month follow-up in 97 aneurysms. Total occlusion rates of 82% were achieved at inception, 82% at 6 months, and 90% at 18 months. Satisfactory occlusion with small neck remnants was present in 17% at inception, 16% at 6 months, and 9% at 18 months. Good neurological outcomes were achieved in 95% at 18 months. Intraprocedural thromboembolic events were recorded in 3% and delayed events in 1% (all in patients taking clopidogrel). Aneurysm recurrence occurred in one patient (1%). Technical complications occurred in 5%. The total complication rate was 10%.ConclusionsWoven SACE is safe, efficacious, and durable at long-term 18-month follow-up, with very low recurrence and re-treatment rates. Preliminary results appear better than those for traditional laser-cut stents.

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