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Endovascular treatment of complex intracranial aneurysms

Mariusz Hofman1, Tomasz Jamróz1, Izabela Jakutowicz1

  • 1Department of Neurosurgery, Medical University of Silesia, Katowice, Poland.

Polish Journal of Radiology
|July 25, 2018
PubMed

Insights

Endovascular treatment of complex intracranial aneurysms (CIAs) is challenging, with a higher rate of procedure abortion compared to non-complex cases. Careful consideration of CIA criteria is vital for invasive treatment planning.

Area of Science:

  • Neurology
  • Vascular Surgery
  • Interventional Radiology

Background:

  • Complex intracranial aneurysms (CIAs) present unique challenges due to size, location, and morphology.
  • These factors necessitate specialized approaches for effective treatment.

Purpose of the Study:

  • To evaluate the outcomes of endovascular treatment for CIAs.
  • To compare the results of CIA treatment with non-complex aneurysms (nCIAs).

Main Methods:

  • Authors developed specific criteria to identify CIAs among endovascularly treated aneurysms (2008-2014).
  • Clinical outcomes were assessed using the Glasgow Outcome Scale (GOS), and radiological outcomes using the Montreal Scale.
  • Aneurysm localization, procedure abortion rates, and intraoperative complications were analyzed.

Main Results:

  • Internal carotid artery was the most frequent location for both CIAs and nCIAs.
  • CIAs had a significantly higher incidence of aborted procedures (25% vs. 7%) and worse Montreal scores compared to nCIAs.
  • Patients with CIAs and subarachnoid hemorrhage (SAH) showed significantly worse clinical outcomes (GOS) than those with nCIAs and SAH.

Conclusions:

  • The proposed criteria for classifying CIAs are important for diagnosis and treatment planning.
  • Identifying an aneurysm as complex increases the likelihood of aborting endovascular procedures due to technical difficulties.
Abstract

Keywords:
aneurysmcomplexembolizationmorphology

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