gms | German Medical Science

57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

11. bis 14.05.2006, Essen

Endovascular treatment of unruptured aneurysms in patients: what is the incidence of brain ischemia?

Endovaskuläre Behandlung asymptomatischer Aneurysmen: wie hoch ist wirklich die Ischämie-Inzidenz?

Meeting Abstract

  • corresponding author K. Kollia - Institut für Diagn. & Interv. Radiolgie & Neuroradiologie, Universitätsklinikum Essen
  • S. Göricke - Institut für Diagn. & Interv. Radiolgie & Neuroradiologie, Universitätsklinikum Essen
  • N. Özkan - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Essen
  • E. Gizewski - Institut für Diagn. & Interv. Radiolgie & Neuroradiologie, Universitätsklinikum Essen
  • M. Forsting - Institut für Diagn. & Interv. Radiolgie & Neuroradiologie, Universitätsklinikum Essen
  • I. Wanke - Institut für Diagn. & Interv. Radiolgie & Neuroradiologie, Universitätsklinikum Essen

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocFR.06.02

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2006/06dgnc034.shtml

Veröffentlicht: 8. Mai 2006

© 2006 Kollia et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

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Objective: Endovascular embolization of unruptured, asymptomatic aneurysms using platinum coils has gained increasing acceptance as an alternative to surgery. Our purpose was to determine the incidence of ischemic events after coiling using diffusion weighted imaging (DWI) correlated with neurological findings.

Methods: In a retrospective study 135 patients were analyzed over a 2.5-year-period. MRI including diffusion-weighted imaging was performed within 72 hours after elective aneurysm treatment. Embolization was performed under systemic heparinisation and the use of intravenous aspirin during and after the treatment. The pre-procedure workup included digital subtraction angiography and MR imaging. After the procedure, all treated patients were examined by a neurosurgeon or a neurologist. MRI examinations were reviewed by two neuroradiologists. The DWI lesions were classified in 4 groups according to their diameter: 1=1-5mm, 2=6-10mm, 3=11-15 and 4=16-20. Lesions larger than 20mm were classified as partial ischemic strokes.

Results: Diffusion-weighted MRI showed bright lesions in 62 (45%) patients. All lesions except 10 (7.4%) were located ipsilateral to the side of the catheterisation, the most common sites were the territory of the middle and the anterior cerebral artery. 14 (21%) patients developed transient neurological symptoms, 3 of them (2.2%) had persistent neurological deficits. Overall rate of asymptomatic ischemic lesions was 34% (46 of 135 treatments). Thrombembolic lesions appeared to depend on the patient’s age and the thrombus formation during the treatment (p<0,1). Aneurysmal rupture occurred in one case, the patient had no neurological deficits except headache after the treatment.

Conclusions: Silent ischemic events during endovascular treatment are more common despite systemic anticoagulation and antiplatetet therapy. The incidence of symptomatic ischemic infarction (2.2%) is closely related to the patient's age.