Literature DB >> 15090345

Treatment of unruptured aneurysms with GDCs: clinical experience with 247 aneurysms.

Nestor Gonzalez1, Yuichi Murayama, Yih Lin Nien, Neil Martin, John Frazee, Gary Duckwiler, Reza Jahan, Y Pierre Gobin, Fernando Viñuela.   

Abstract

BACKGROUND AND
PURPOSE: The GDC system is a valuable therapeutic alternative to surgical treatment of intracranial aneurysms. We present our clinical experience with the GDC technique used to treat unruptured cerebral aneurysms.
METHODS: This is a retrospective review of 217 patients with 247 unruptured intracranial aneurysms who underwent embolization with GDCs between August 1991 and June 2000. One hundred sixty-seven of the 217 were female patients. Patient age ranged from 13 to 83 years. In 118 patients, the aneurysms were found when unrelated non-neurologic conditions indicated angiography, CT angiography, or MR angiography (group 1). Fifty-one patients with mass effect symptoms comprised group 2, 12 patients with aneurysms associated with arteriovenous malformations or tumors of the brain comprised group 3, 17 patients with unruptured aneurysms treated during the chronic phase of subarachnoid hemorrhage (SAH) comprised group 4, and 19 patients treated during the acute phase of SAH due to another ruptured aneurysm comprised group 5.
RESULTS: Angiographic results revealed complete occlusion in 138 of 247 aneurysms (55.9%), neck remnants in 92 (37.2%), and incomplete occlusion in three (1.2%). GDC embolization was attempted unsuccessfully in 14 aneurysms (5.7%). Of the 198 patients without acute SAH (groups 1-4), 186 (93.9%) of 198 remained neurologically unchanged. Eleven of the 217 patients (5.1%) experienced neurologic deterioration caused by immediate procedural complications. One patient died (0.5%) as a result of aneurysmal rupture during embolization. For asymptomatic patients and those treated after the chronic period of SAH, the mean hospitalization stay was 2.9 days.
CONCLUSION: GDC technology constitutes safe treatment for unruptured aneurysms, with successful anatomic and clinical results and low complication rates achieved.

Entities:  

Mesh:

Year:  2004        PMID: 15090345      PMCID: PMC7975602     

Source DB:  PubMed          Journal:  AJNR Am J Neuroradiol        ISSN: 0195-6108            Impact factor:   3.825


  23 in total

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8.  Initial and recurrent bleeding are the major causes of death following subarachnoid hemorrhage.

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  32 in total

1.  Letter to the editor. Anticoagulant and antithrombotic agent use in intracranial aneurysm treatment call for a consensus.

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Journal:  Interv Neuroradiol       Date:  2006-02-10       Impact factor: 1.610

2.  A less invasive approach for ruptured aneurysm with intracranial hematoma: coil embolization followed by clot evacuation.

Authors:  Je Hoon Jeong; Jun Seok Koh; Eui Jong Kim
Journal:  Korean J Radiol       Date:  2007 Jan-Feb       Impact factor: 3.500

Review 3.  Materials and techniques for coiling of cerebral aneurysms: how much scientific evidence do we have?

Authors:  W Kurre; J Berkefeld
Journal:  Neuroradiology       Date:  2008-09-19       Impact factor: 2.804

4.  Treatment related morbidity of unruptured intracranial aneurysms: results of a prospective single centre series with an interdisciplinary approach over a 6 year period (1999-2005).

Authors:  Rüdiger Gerlach; Jürgen Beck; Matthias Setzer; Hartmut Vatter; Joachim Berkefeld; Richard Du Mesnil de Rochemont; Andreas Raabe; Volker Seifert
Journal:  J Neurol Neurosurg Psychiatry       Date:  2007-01-08       Impact factor: 10.154

5.  Endovascular therapy of 500 small asymptomatic unruptured intracranial aneurysms.

Authors:  H Oishi; M Yamamoto; T Shimizu; K Yoshida; H Arai
Journal:  AJNR Am J Neuroradiol       Date:  2012-01-12       Impact factor: 3.825

6.  Effect of endovascular treatment on headache in elderly patients with unruptured intracranial aneurysms.

Authors:  D-Q Gu; C-Z Duan; X-F Li; X-Y He; L-F Lai; S-X Su
Journal:  AJNR Am J Neuroradiol       Date:  2012-12-06       Impact factor: 3.825

7.  The interdisciplinary treatment of unruptured intracranial aneurysms.

Authors:  Volker Seifert; Rüdiger Gerlach; Andreas Raabe; Erdem Güresir; Jürgen Beck; Andrea Szelényi; Matthias Setzer; Hartmut Vatter; Richard Du Mesnil de Rochemont; Friedhelm Zanella; Matthias Sitzer; Joachim Berkefeld
Journal:  Dtsch Arztebl Int       Date:  2008-06-20       Impact factor: 5.594

8.  Validation and initial application of a semiautomatic aneurysm measurement software: a tool for assessing volumetric packing attenuation.

Authors:  H Takao; T Ishibashi; T Saguchi; H Arakawa; M Ebara; K Irie; Y Murayama
Journal:  AJNR Am J Neuroradiol       Date:  2013-11-14       Impact factor: 3.825

9.  Clinical analysis of giant intracranial aneurysms with endovascular embolization.

Authors:  Sang Woo Ha; Suk Jung Jang
Journal:  J Cerebrovasc Endovasc Neurosurg       Date:  2012-03-31

10.  Feasibility, procedural morbidity and mortality, and long-term follow-up of endovascular treatment of 321 unruptured aneurysms.

Authors:  S Gallas; J Drouineau; J Gabrillargues; A Pasco; C Cognard; L Pierot; D Herbreteau
Journal:  AJNR Am J Neuroradiol       Date:  2007-10-09       Impact factor: 3.825

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