Endovascular Coil Embolization of Very Small Intracranial Aneurysms |
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Authors: | Kil Sung Chae Pyoung Jeon Keon Ha Kim Sung Tae Kim Hyung Jin Kim Hong Sik Byun |
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Affiliation: | 1Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.;2Department of Neurosurgery, Bong Seng Memorial Hospital, Busan 601-723, Korea. |
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Abstract: | ObjectiveWe aimed to evaluate the results of endovascular coil embolization for very small aneurysms (≤ 3 mm).Materials and MethodsBetween March 2005 and December 2008, a total of 31 very small aneurysms in 30 patients were treated by coil embolization. Of the 31 aneurysms, five (16%) were ruptured, as opposed to 26 (84%) that were not. We assessed the procedural complications, immediate angiographic outcome after coiling, clinical outcome, and follow-up MR angiography (MRA).ResultsTwo thromboembolic complications occurred during the procedure, but did not lead to any persistent neurologic deficit. No procedural aneurysmal rupture was observed and procedure-related morbidity and mortality were both 0%. Occlusion was adequate in 25 aneurysms (81%) and incomplete in six aneurysms (19%). The clinical outcomes of five patients with ruptured aneurysms were good (Glasgow outcome scale ≥ 4), with no bleeding of the treated aneurysms during a mean follow-up period of 13.3 months. On 27 follow-up MRA, there was no recurrence, and the five incompletely occluded aneurysms showed a spontaneous amelioration resulting in an adequate occlusion.ConclusionCoil embolization of very small aneurysms is technically feasible with good results. The long-term efficacy and the potential as a standard treatment strategy remain to be determined by randomized large trials. |
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Keywords: | Intracranial aneurysm Endovascular treatment Outcome |
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