open access

Vol 47, No 5 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2012-03-25
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Results of endovascular treatment of aneurysms depending on their size, volume and coil packing density

Daniel Knap, Katarzyna Gruszczyńska, Robert Partyka, Damian Ptak, Małgorzata Korzekwa, Miłosz Zbroszczyk, Jan Baron
DOI: 10.5114/ninp.2013.38226
·
Neurol Neurochir Pol 2013;47(5):467-475.

open access

Vol 47, No 5 (2013)
ARTYKUŁ ORYGINALNY
Submitted: 2012-03-25

Abstract

Background and purpose

In contrast to neurosurgery, which is more efficient, endovascular treatment (EVT) is less invasive. The main purpose of EVT is complete occlusion of the aneurysm and protection from subarachnoid haemorrhage. Accurate measurements of the aneurysm (size, volume) obtained using a 3D digital subtraction angiography (DSA) workstation can assist in the proper assessment of coil packing density (CPD), which affects possible distant recanalization. The main disadvantage of endovascular treatment of intracranial aneurysms compared to neurosurgery is the high recurrence rate. We evaluated the results of endovascular treatment of aneurysms depending on their size, volume and coil packing density.

Material and methods

Thirty-five patients with intracranial aneurysms underwent endovascular embolization with bare platinum coils. Three-dimensional DSA was used to evaluate aneurysms’ morphology. Eighteen patients underwent 3D DSA follow-up 6-45 months after treatment. Initial and follow-up results of embolization were assessed with the Raymond-Montreal scale. The impact of aneurysms’ morphology, volume and initial CPD on endovascular treatment was evaluated.

Results

Among 35 patients, complete initial embolization was achieved in 74%. Mean initial aneurysm volume in 3D DSA was 0.517 mL and decreased significantly after embolization. Initial CPD varied from 74% to 2% depending on aneurysm diameter (12.1% for aneurysms ≥ 10 mm, 22.5% for aneurysms < 10 mm). Results of embolization on the Raymond-Montreal scale significantly depended on aneurysms’ CPD. Aneurysms’ recanalization rate on 3D DSA follow-up was 36%, with complete recanalization in 3.3%.

Conclusions

We can achieve a better outcome if size and volume of the aneurysm sac is smaller and if CPD is higher.

Abstract

Background and purpose

In contrast to neurosurgery, which is more efficient, endovascular treatment (EVT) is less invasive. The main purpose of EVT is complete occlusion of the aneurysm and protection from subarachnoid haemorrhage. Accurate measurements of the aneurysm (size, volume) obtained using a 3D digital subtraction angiography (DSA) workstation can assist in the proper assessment of coil packing density (CPD), which affects possible distant recanalization. The main disadvantage of endovascular treatment of intracranial aneurysms compared to neurosurgery is the high recurrence rate. We evaluated the results of endovascular treatment of aneurysms depending on their size, volume and coil packing density.

Material and methods

Thirty-five patients with intracranial aneurysms underwent endovascular embolization with bare platinum coils. Three-dimensional DSA was used to evaluate aneurysms’ morphology. Eighteen patients underwent 3D DSA follow-up 6-45 months after treatment. Initial and follow-up results of embolization were assessed with the Raymond-Montreal scale. The impact of aneurysms’ morphology, volume and initial CPD on endovascular treatment was evaluated.

Results

Among 35 patients, complete initial embolization was achieved in 74%. Mean initial aneurysm volume in 3D DSA was 0.517 mL and decreased significantly after embolization. Initial CPD varied from 74% to 2% depending on aneurysm diameter (12.1% for aneurysms ≥ 10 mm, 22.5% for aneurysms < 10 mm). Results of embolization on the Raymond-Montreal scale significantly depended on aneurysms’ CPD. Aneurysms’ recanalization rate on 3D DSA follow-up was 36%, with complete recanalization in 3.3%.

Conclusions

We can achieve a better outcome if size and volume of the aneurysm sac is smaller and if CPD is higher.

Get Citation

Keywords

intracranial aneurysms, embolization, recanalization, coil packing density

About this article
Title

Results of endovascular treatment of aneurysms depending on their size, volume and coil packing density

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 47, No 5 (2013)

Pages

467-475

DOI

10.5114/ninp.2013.38226

Bibliographic record

Neurol Neurochir Pol 2013;47(5):467-475.

Keywords

intracranial aneurysms
embolization
recanalization
coil packing density

Authors

Daniel Knap
Katarzyna Gruszczyńska
Robert Partyka
Damian Ptak
Małgorzata Korzekwa
Miłosz Zbroszczyk
Jan Baron

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