Article
Ischemic events after endovascular treatment of unruptured aneurysms
Thrombembolische Ereignisse nach endovaskulärer Behandlung asymptomatischer Aneurysmen
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Published: | May 4, 2005 |
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Outline
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Objective
The purpose of this study was to evaluate the frequency and causes of thromboembolic events associated with endovascular embolization of asymptomatic aneurysms. A correlation between radiologic findings (aneurysm size, localisation, embolization time, and number of coils used, as well as patients age) was evaluated with the occurrence of thromboembolic events and clinical findings.
Methods
We evaluated 68 patients treated for unruptured intracranial aneurysms (mean age 49 years). For DWI we could include 50 aneurysms. Aneurysm size was 3 - 15 mm. Hyperintense lesions on DWI were analysed.
Results
Complete occlusion of the aneurysms was achieved in 55/68 (82%). One patient had a transient paresis. There was one infarction and one aneurysm rupture during the procedure with no consecutive neurological symptoms. We found new hyperintense lesions in 21/50 (42%). In 43% of these there was only one lesion smaller than 2mm. In 33% there was more than one lesion <2mm; in 19% we found a lesion of 2-10mm in size. In one case a lesion >10mm occurred. There was no correlation between aneurysm location and the occurrence of lesions. There was no correlation concerning the number of coils used, the size of the aneurysm, patient age and embolisation time. Mortality rate was 0%, morbidity 4.0%. If the 18 aneurysms where no DWI was obtained are included morbidity is 2.9%.
Conclusions
The high rate of thromboembolic events suggests that heparin is not sufficient to prevent ischemic lesions. Thus the use of other antiplatelet drugs, such as ASS and GPIIIb/IIa analoga should be considered.