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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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Coiling of non-ruptured MCA aneurysms

Meeting Abstract

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  • M. Schumacher - Abteilung für Neuroradiologie, Neurozentrum, Universitätsklinikum Freiburg
  • O.Y. Mansour - Department of Neurology, Alexandria University Hospital, Egypt

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. DocP 010

doi: 10.3205/11dgnc231, urn:nbn:de:0183-11dgnc2319

Published: April 28, 2011

© 2011 Schumacher 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: In the treatment of unruptured intracranial aneurysms, endovascular coiling has shown equal or superior results to clipping. But for unruptured MCA-aneurysms, coiling has been limited. The study analyzes ruptured and non ruptured aneurysms with respect to their geometry in a pre-treatment group. In a second group of unruptured MCA-aneurysms, the endovascular treatment results are evaluated.

Methods: For morphology comparison, 126 MCA aneurysms were classified according their anatomical appearance. In a separate group of 70 patients (30 men, 40 women, 22-77 years, mean age 59) with 76 unruptured MCA-aneurysms the technique of treatment and clinical results were evaluated.

Results: The location of the aneurysms was at the media trifurcation in 73%, M1-segment in 22% and MCA branch in 5%. A large neck was found in 53.9% and a narrow neck in 46.1%. For treatment modalities, a single catheter technique, multi-catheter technique, balloon-assisted coiling, stent-assisted coiling and multi-catheter with balloon technique were used. The failure rate for coiling was 1.3%, periprocedural complications occurred in 1.4 % and transient ischemic events in 2.8%; persistent morbidity was 1.4 % and the mortality rate was 1.4%. A minimal partial recanalization was seen in 8.6% on follow-up angiography (6–24 months, mean 11 months). A clear recurrence was found in 4.3%.

Conclusions: ACM aneurysms should not be allocated solely to clipping since they are well treatable endovascularly with good results.