Puyuan Zhao1, Deyuan Zhu1, Wanling Wen1, Yu Zhou1, Yibin Fang1, Qiang Li1, Rui Zhao1, Bo Hong1, Yi Xu1, Jianmin Liu2, Qinghai Huang3. 1. Department of Neurosurgery, Second Military Medical University Changhai Hospital, Shanghai, China. 2. Department of Neurosurgery, Second Military Medical University Changhai Hospital, Shanghai, China. Electronic address: chstroke@163.com. 3. Department of Neurosurgery, Second Military Medical University Changhai Hospital, Shanghai, China. Electronic address: ocinhqh@163.com.
Abstract
OBJECTIVE: To evaluate safety and efficacy of endovascular treatment of middle cerebral artery dissecting aneurysms (MCADAs). METHODS: Between July 2009 and April 2016, 14 patients with MCADAs received endovascular treatment. MCADAs were identified by their unique radiographic features on cerebral angiography. Baseline characteristics, angiographic features, and angiographic and clinical outcomes were analyzed retrospectively. RESULTS: All 14 MCADAs (including 6 ruptured and 8 unruptured) were successfully treated with the endovascular approach. Stent-assisted coiling was used in 12 cases, coil alone in 1 case, and parent vessel occlusion in 1 case. Angiographic follow-up data were available for all patients at 6 months after treatment. Of 14 MCADAs, 10 were completely occluded, and 4 were improved (near occlusion). All parent arteries and covered perforators remained patent in the non-parent vessel occlusion group. No ischemic strokes or other complications were observed at 1-year clinical follow-up. CONCLUSIONS: Our data suggest that endovascular treatment of MCADAs appears to be safe and effective. The choice of treatment method needs to be individualized. Larger studies are required to evaluate these promising results.
OBJECTIVE: To evaluate safety and efficacy of endovascular treatment of middle cerebral artery dissecting aneurysms (MCADAs). METHODS: Between July 2009 and April 2016, 14 patients with MCADAs received endovascular treatment. MCADAs were identified by their unique radiographic features on cerebral angiography. Baseline characteristics, angiographic features, and angiographic and clinical outcomes were analyzed retrospectively. RESULTS: All 14 MCADAs (including 6 ruptured and 8 unruptured) were successfully treated with the endovascular approach. Stent-assisted coiling was used in 12 cases, coil alone in 1 case, and parent vessel occlusion in 1 case. Angiographic follow-up data were available for all patients at 6 months after treatment. Of 14 MCADAs, 10 were completely occluded, and 4 were improved (near occlusion). All parent arteries and covered perforators remained patent in the non-parent vessel occlusion group. No ischemic strokes or other complications were observed at 1-year clinical follow-up. CONCLUSIONS: Our data suggest that endovascular treatment of MCADAs appears to be safe and effective. The choice of treatment method needs to be individualized. Larger studies are required to evaluate these promising results.