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French collaborative group series on giant intracranial aneurysms: Current management
S Derrey1, G Penchet1, L Thines1
1Department of Neurosurgery, Rouen University Hospital, 1, rue de Germont, 76031 Rouen cedex, France.
Neuro-Chirurgie
|March 21, 2014
Summary
Endovascular treatment and good initial clinical status predict favorable outcomes for giant intracranial aneurysms. Absence of neurological deterioration is also key for successful management of these challenging cases.
Area of Science:
- Neurosurgery
- Endovascular Therapy
- Cerebrovascular Diseases
Background:
- Giant intracranial aneurysms (GIAs) pose significant therapeutic challenges.
- Contemporary management strategies for GIAs require thorough evaluation.
Purpose of the Study:
- To review French multicenter experience in treating GIAs.
- To assess current management and identify predictors of favorable outcomes.
Main Methods:
- Retrospective multicenter study of 79 patients treated for GIAs (2004-2008).
- Analysis of diagnostic circumstances, clinical status (WFNS), aneurysmal features, and treatment procedures.
- Outcome assessed at 6 months using modified Rankin Scale (mRS).
- Multivariate logistic regression to identify predictive factors for favorable outcome (mRS 0-2).
Main Results:
- 57% of patients achieved a favorable outcome at 6 months.
- Predictive factors for favorable outcome included good initial clinical status (especially post-SAH), endovascular treatment, and absence of neurological deterioration.
- Endovascular treatment, particularly parent vessel occlusion, showed efficacy.
Conclusions:
- Favorable outcomes (57%) were achieved despite challenges, particularly in ruptured aneurysms.
- Good clinical status, endovascular treatment, and absence of neurological deterioration are crucial for favorable outcomes.
- Endovascular treatment is a valuable option for GIAs, with durability requiring multidisciplinary neurovascular team consideration.
Keywords:
Anévrisme cérébral géantCoiling endovasculaireEndovascular coilingGiant cerebral aneurysmManagementMicrosurgical clippingOutcomePredictive factorsPseudo-tumor syndromeSyndrome pseudo-tumeurTraitement microchirurgicalMore Related Videos
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