Dae Yoon Kim1, Jung Cheol Park2, Jae Kyun Kim3, Yu Sub Sung4, Eun Suk Park5, Jae Hyuk Kwak6, Choong-Gon Choi7, Deok Hee Lee7. 1. Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; 7 Department of Radiology, Bundang Jesaeng Hospital, Gyeonggi-do, Korea. 2. Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 3. Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea. 4. Biomedical Imaging infrastructure, Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. 5. Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; Department of Neurosurgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. 6. Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ; 6 Department of Neurology, Daegu Fatima Hospital, Daegu, Korea. 7. Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Abstract
PURPOSE: Diffusion-weighted MR images (DWI) obtained after endovascular treatment of cerebral aneurysms frequently show multiple high-signal intensity (HSI) dots. The purpose of this study was to see whether we could reduce their incidence after embolization of unruptured cerebral aneurysms by modification of our coiling technique, which involves the deliberate aspiration of the microcatheter lumen right after delivery of each detachable coil into the aneurysm sac. MATERIALS AND METHODS: From January 2011 to June 2011, all 71 patients with unruptured cerebral aneurysms were treated using various endovascular methods. During the earlier period, 37 patients were treated using our conventional embolization technique (conventional period). Then 34 patients were treated with a modified coiling technique (modified period). DWI was obtained on the following day. We compared the occurrence of any DWI HSI lesions and the presence of the symptomatic lesions during the two time periods. RESULTS: The incidence of the DWI HSI lesions differed significantly at 89.2% (33/37) during the conventional period and 26.5% (9/34) during the modified period (p < 0.0001). The incidence of symptomatic lesions differed between the two periods (29.7% during the conventional period vs. 2.9% during the modified period, p < 0.003). CONCLUSION: Aspiration of the inner content of the microcatheter right after detachable coil delivery was helpful for the reduction of the incidence of microembolisms after endovascular coil embolization for the treatment of unruptured cerebral aneurysms.
PURPOSE: Diffusion-weighted MR images (DWI) obtained after endovascular treatment of cerebral aneurysms frequently show multiple high-signal intensity (HSI) dots. The purpose of this study was to see whether we could reduce their incidence after embolization of unruptured cerebral aneurysms by modification of our coiling technique, which involves the deliberate aspiration of the microcatheter lumen right after delivery of each detachable coil into the aneurysm sac. MATERIALS AND METHODS: From January 2011 to June 2011, all 71 patients with unruptured cerebral aneurysms were treated using various endovascular methods. During the earlier period, 37 patients were treated using our conventional embolization technique (conventional period). Then 34 patients were treated with a modified coiling technique (modified period). DWI was obtained on the following day. We compared the occurrence of any DWI HSI lesions and the presence of the symptomatic lesions during the two time periods. RESULTS: The incidence of the DWI HSI lesions differed significantly at 89.2% (33/37) during the conventional period and 26.5% (9/34) during the modified period (p < 0.0001). The incidence of symptomatic lesions differed between the two periods (29.7% during the conventional period vs. 2.9% during the modified period, p < 0.003). CONCLUSION: Aspiration of the inner content of the microcatheter right after detachable coil delivery was helpful for the reduction of the incidence of microembolisms after endovascular coil embolization for the treatment of unruptured cerebral aneurysms.
Authors: Rupal I Mehta; Rashi I Mehta; Orestes E Solis; Reza Jahan; Noriko Salamon; Jonathan M Tobis; William H Yong; Harry V Vinters; Michael C Fishbein Journal: Mod Pathol Date: 2010-03-19 Impact factor: 7.842
Authors: A Biondi; C Oppenheim; E Vivas; A Casasco; T Lalam; N Sourour; L L Jean; D Dormont; C Marsault Journal: AJNR Am J Neuroradiol Date: 2000-05 Impact factor: 4.966