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Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Intra-aneurysmal thrombus modification after flow-diversion.

Mario Zanaty1, Pascal M Jabbour1, Roula Bou Sader1

  • 1Department of Neurosurgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, 901 Walnut Street, 3rd Floor, Philadelphia, PA 19107, USA.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|September 7, 2014
PubMed
Summary
This summary is machine-generated.

Flow diversion effectively treats large intracranial aneurysms by reducing thrombus size, leading to significant symptom improvement. This treatment promotes aneurysm occlusion and regression, resolving mass effect symptoms.

Keywords:
Flow-diversionGiant aneurysmsIntracranial aneurysmsLarge aneurysmsPartially thrombosed aneurysmsPipeline Embolization DeviceThrombi

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Area of Science:

  • Neurology
  • Interventional Neuroradiology
  • Vascular Surgery

Background:

  • Large and giant intracranial aneurysms can cause mass effect symptoms.
  • Flow diversion is an established treatment for these complex aneurysms.

Purpose of the Study:

  • To evaluate thrombus modification after Pipeline Embolization Device treatment in large/giant intracranial aneurysms.
  • To assess the impact of thrombus changes on patient symptoms and outcomes.

Main Methods:

  • Retrospective review of eight patients with partially thrombosed large or giant aneurysms.
  • Treatment with the Pipeline Embolization Device.
  • 1-year follow-up assessing aneurysm occlusion, thrombus size, and symptom resolution.

Main Results:

  • Complete aneurysm occlusion achieved in 75% of patients at 1 year.
  • Average longest thrombus diameter decreased from 22.31 mm to 14.05 mm.
  • Thrombus regression in 7/8 patients, correlating with significant symptom improvement and becoming asymptomatic.

Conclusions:

  • Flow diversion effectively reduces intra-aneurysmal thrombus size in large/giant aneurysms.
  • Thrombus modification, rather than aneurysm size, appears to be a key factor in symptom resolution.
  • Pipeline Embolization Device treatment leads to favorable outcomes, including symptom relief.