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Contrast stasis in large and giant internal carotid artery aneurysms as a good prognostic factor for endovascular
Sachio Suzuki1, Akira Kurata, Masaru Yamada
1Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Japan. ssachio@med.kitasato-u.ac.jp
Insights
Contrast stasis in large or giant aneurysms is a good predictor of successful endovascular embolization outcomes. This finding helps identify suitable candidates for this minimally invasive treatment.
Area of Science:
- Vascular Surgery
- Interventional Radiology
- Neuroradiology
Background:
- Predicting successful outcomes for large and giant aneurysms treated with endovascular surgery is crucial.
- Identifying reliable prognostic criteria, particularly angiographic signs, is essential for patient selection.
Purpose of the Study:
- To determine angiographic predictors for successful endovascular embolization of large and giant aneurysms.
- To identify criteria that prognosticate good results before endovascular treatment.
Main Methods:
- Retrospective study of 45 patients with large or giant aneurysms undergoing endovascular embolization.
- Patients divided into two groups based on angiographic findings: Group A (contrast medium stasis on venous phase) and Group B (other findings).
- Evaluation of the relationship between contrast stasis and endovascular embolization outcomes.
Main Results:
- No significant difference in aneurysm size between groups.
- Significant differences observed in neck/dome ratio (P=0.04) and neck size (P=0.003) between groups.
- Superior morphological outcome in Group A (contrast stasis) compared to Group B (P=0.03).
Conclusions:
- Contrast stasis on angiography is a significant predictor of favorable outcomes in patients with large or giant aneurysms undergoing endovascular embolization.
- Neck/dome ratio and neck size are also important factors differentiating treatment groups.
- Further hemodynamic studies with larger patient cohorts may uncover additional predictive factors for successful endovascular treatment.
Objective:
Before treatment for large and giant aneurysms, we need some of the predictors to prognose a good result. In this retrospective study, we attempted to determine criteria such as angiographic signs to identify good candidates for effective endovascular surgery.
Methods:
This study involved 45 patients with large or giant aneurysms treated by endovascular embolization. For angiographic study, we delivered a bolus injection of contrast medium. All aneurysms were confirmed angiographically and the morphology was defined in detail before endovascular embolization. We divided the patients into two groups based on angiographic findings. Group A (n=16) manifested stasis of the contrast medium in the aneurysm on venous phase. Group B (n=29) exhibited other findings. We retrospectively evaluated the relationship between stasis of the contrast medium in the aneurysm and results of endovascular embolization.
Results And Discussion:
There was no significant difference between the two groups with respect to the size of the aneurysm. However, the neck/dome ratio (P=0·04) and size of the neck (P=0·003) were significantly different between groups A and B. The morphological outcome was better in group A than group B (P=0·03). We demonstrate that contrast stasis is a good predictor of outcome in patients with large or giant aneurysms to consider the endovascular embolization. Hemodynamic studies on large patient populations may reveal other factors predictive of a good treatment outcome.
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