gms | German Medical Science

61st Annual Meeting of the German Society of Neurosurgery (DGNC) as part of the Neurowoche 2010
Joint Meeting with the Brazilian Society of Neurosurgery on the 20 September 2010

German Society of Neurosurgery (DGNC)

21 - 25 September 2010, Mannheim

Balloon-assisted coil-embolization of intracranial aneurysms: Influence of aneurysm-morphology on outcome

Meeting Abstract

  • Anastasios Mpotsaris - Klinik für Radiologie, Neuroradiologie und interventionelle Therapie, Klinikum Vest, Recklinghausen, Deutschland
  • Christian Loehr - Klinik für Radiologie, Neuroradiologie und interventionelle Therapie, Klinikum Vest, Recklinghausen, Deutschland
  • Maximillian Puchner - Klinik für Neurochirurgie, Klinikum Vest, Recklinghausen, Deutschland
  • Werner Weber - Klinik für Radiologie, Neuroradiologie und interventionelle Therapie, Klinikum Vest, Recklinghausen, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocV1585

DOI: 10.3205/10dgnc060, URN: urn:nbn:de:0183-10dgnc0609

Published: September 16, 2010

© 2010 Mpotsaris et al.
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Outline

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Objective: To prospectively assess short-term, mid-term and long-term results of patients with intracranial aneurysm treated with balloon-assisted coil-embolization on the basis of aneurysm morphology and localization.

Methods: Analysis of all cases featuring balloon-assisted coil-embolization including incidental and ruptured aneurysms since April 2008. Case data collected included demographic data, clinical findings and angiographic results on admission, postinterventionally and during follow-up of up to 18 months. Outcome (Glasgow Outcome Score) was assessed by a neurosurgeon.

Results: To date (March 2010) 242 aneurysms have been treated with coil-embolization, 52 with balloon-assistance. Out of these, 20 patients had incidental aneurysms, 32 had initial subarachnoid hemorrhage (SAH). 38 aneurysms were located in the anterior circulation, 14 in the posterior circulation. 19 were sidewall-aneurysms, 33 were bifurcation-aneurysms (13 centric, 20 excentric). Sidewall-aneurysms and centric bifurcation-aneurysms showed no clinically persistent complications and had good outcome. The sub-group of excentric bifurcation-aneurysms (20 of 52) presented with 6 cases of clinically relevant, procedural complications (thrombosis / vasospasm). In each of those cases the arteries adjacent to the excentric bifurcation-aneurysm had unequal diameters and balloon-placement in the artery bearing the aneurysm was only achieved in 3 of 6 patients.

Conclusions: Balloon-assisted coil-embolization of sidewall-aneurysms and centric bifurcation-aneurysms is technically feasible and midterm angiographic and clinical results present good outcome. Endovascular treatment of excentric bifurcation-aneurysms is technically more challenging and seems to have a potentially higher risk for procedural complications. For this sub-category of intracranial aneurysms neurosurgical treatment might be preferable.