BACKGROUND AND PURPOSE: Despite major progress in treating aneurysms by coil embolization, the complete occlusion of aneurysms of >10 mm in diameter (large/giant aneurysms) remains challenging. We present a novel endovascular treatment method for large and giant cerebral aneurysms called the "maze-making and solving" technique and compare the short-term follow-up results of this technique with those of conventional coil embolization. MATERIALS AND METHODS: Eight patients (65 ± 11.5 years of age, 7 women) with large/giant unruptured nonthrombosed cerebral aneurysm (mean largest aneurysm dimension, 19 ± 4.4 mm) were treated by the maze-making and solving technique, a combination of the double-catheter technique and various assisted techniques. The coil-packing attenuation, postoperative courses, and recurrence rate of this maze group were compared with 30 previous cases (conventional group, 65.4 ± 13.0 years of age; 22 women; mean largest aneurysm dimension, 13.4 ± 3.8 mm). RESULTS: Four maze group cases were Raymond class 1; and 4 were class 2 as indicated by immediate postsurgical angiography. No perioperative deaths or major strokes occurred. Mean packing attenuation of the maze group was significantly higher than that of the conventional group (37.4 ± 5.9% versus 26.2 ± 5.6%). Follow-up angiography performed at 11.3 ± 5.4 months revealed no recurrence in the maze group compared with 39.2% in the conventional group. CONCLUSIONS: The maze-making and solving technique achieves high coil-packing attenuation for efficient embolization of large and giant cerebral aneurysms with a low risk of recurrence.
BACKGROUND AND PURPOSE: Despite major progress in treating aneurysms by coil embolization, the complete occlusion of aneurysms of >10 mm in diameter (large/giant aneurysms) remains challenging. We present a novel endovascular treatment method for large and giant cerebral aneurysms called the "maze-making and solving" technique and compare the short-term follow-up results of this technique with those of conventional coil embolization. MATERIALS AND METHODS: Eight patients (65 ± 11.5 years of age, 7 women) with large/giant unruptured nonthrombosed cerebral aneurysm (mean largest aneurysm dimension, 19 ± 4.4 mm) were treated by the maze-making and solving technique, a combination of the double-catheter technique and various assisted techniques. The coil-packing attenuation, postoperative courses, and recurrence rate of this maze group were compared with 30 previous cases (conventional group, 65.4 ± 13.0 years of age; 22 women; mean largest aneurysm dimension, 13.4 ± 3.8 mm). RESULTS: Four maze group cases were Raymond class 1; and 4 were class 2 as indicated by immediate postsurgical angiography. No perioperative deaths or major strokes occurred. Mean packing attenuation of the maze group was significantly higher than that of the conventional group (37.4 ± 5.9% versus 26.2 ± 5.6%). Follow-up angiography performed at 11.3 ± 5.4 months revealed no recurrence in the maze group compared with 39.2% in the conventional group. CONCLUSIONS: The maze-making and solving technique achieves high coil-packing attenuation for efficient embolization of large and giant cerebral aneurysms with a low risk of recurrence.
Authors: Tibor Becske; David F Kallmes; Isil Saatci; Cameron G McDougall; István Szikora; Giuseppe Lanzino; Christopher J Moran; Henry H Woo; Demetrius K Lopes; Aaron L Berez; Daniel J Cher; Adnan H Siddiqui; Elad I Levy; Felipe C Albuquerque; David J Fiorella; Zsolt Berentei; Miklós Marosfoi; Saruhan H Cekirge; Peter K Nelson Journal: Radiology Date: 2013-02-15 Impact factor: 11.105
Authors: C G McDougall; S Claiborne Johnston; A Gholkar; S L Barnwell; J C Vazquez Suarez; J Massó Romero; J C Chaloupka; A Bonafe; A K Wakhloo; D Tampieri; C F Dowd; A J Fox; S J Imm; K Carroll; A S Turk Journal: AJNR Am J Neuroradiol Date: 2014-01-30 Impact factor: 3.825
Authors: Menno Sluzewski; Willem Jan van Rooij; Marian J Slob; Javier Oliván Bescós; Cornelis H Slump; Douwe Wijnalda Journal: Radiology Date: 2004-04-29 Impact factor: 11.105
Authors: J Raymond; R Klink; M Chagnon; S L Barnwell; A J Evans; J Mocco; B L Hoh; A S Turk; R D Turner; H Desal; D Fiorella; S Bracard; A Weill; F Guilbert; D Roy Journal: AJNR Am J Neuroradiol Date: 2014-06-19 Impact factor: 3.825
Authors: Nohra Chalouhi; Aaron S Dumont; David Hasan; Stavropoula Tjoumakaris; L Fernando Gonzalez; Robert M Starke; Richard Dalyai; Sedeek El Moursi; Robert Rosenwasser; Pascal Jabbour Journal: Neurosurgery Date: 2012-08 Impact factor: 4.654