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62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

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Long-term results of endovascular treatment of intracranial aneurysms

Meeting Abstract

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  • K.A. Leber - Universitätskliniken für Neurochirurgie, Medizinische Universität Graz
  • G. Maderbacher - Universitätskliniken für Neurochirurgie, Medizinische Universität Graz
  • V. Gellner - Universitätskliniken für Neurochirurgie, Medizinische Universität Graz
  • S. Kurschel-Lackner - Universitätskliniken für Neurochirurgie, Medizinische Universität Graz
  • G.E. Klein - Universitätskliniken für Radiologie, Medizinische Universität Graz

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocMO.11.03

doi: 10.3205/11dgnc080, urn:nbn:de:0183-11dgnc0809

Published: April 28, 2011

© 2011 Leber et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Mid-term results of endovascular treatment of intracranial aneurysms yielded promising results. Our study focuses on the long-term results in terms of efficiency, recurrence rates and overall complications over a period of 10 years.

Methods: We included 91 patients with intracranial aneurysms (52 with ruptured and 39 with unruptured aneurysms). A total of 119 aneurysms were treated by endovascular coiling from 1992 to 1998. Endpoints according to treatment-related morbidity and mortality (Glasgow Outcome Scale) were obtained from 75 patients as well as radiological data on occlusion rates could be obtained from 70 surviving patients after a mean follow-up of 10 years.

Results: Treatment-related mortality was found in 6.7% (5/75), four of these patients had a ruptured aneurysm. Treatment related morbidity was 18.6%, in 8 patients with unruptured (11.4%) and in 6 patients with ruptured aneurysms (8.5%). A primary total occlusion of the lesion could be achieved in 66.3% (61/92). In 47.8% (44/92) of the aneurysms a recurrence was noted after an average of 4.2 years. Twenty-six of them required at least one further embolization. Recurrences were more often detected in large aneurysms (p < 0.05). A re-recurrence was seen in 61% (16/26) after a successful re-treatment.

Conclusions: The comparatively high mortality rate reflects the fact that initially poor grade patients were also treated by endovascular methods. The long-term stability of endovascular treatment seems to be less reliable than clipping. Especially large aneurysms need to be observed meticulously in the long-term. Perhaps the additional use of stents and/or flow-diverters will help to lower the recurrence rates in the endovascular field.