Endovascular Treatment of Wide necked Aneurysms

Abstract

Objectives : Despite rapid technologic advances and development of new devices in endovascular technology, wide?]necked intracranial aneurysm are often difficult to treat properly and safely. Because their high recannalization rate and coil compaction, variety of techniques aimed to improving the ability to treatment of these aneurysm without adjunctive techniques. We report our experience with embolization of wide necked aneurysms using various designed coils alone.

Methods : wide necked aneurysms using new designed coils were treated from April 2004 to February 2007. 4 kinds of new designed coils(GDC?]3D,GDC 360, MicroPlex complex, Nexus 3?]D) were used as the initial coil for suitable to each wide necked aneurysm considered to the characteristics of coil and shape of aneurysms. The immediate postoperative angiographies, follow?]up angiographies, medial record and operation records were reviewed retrospectively.

Results : 12 patients were comprised of 3 male and 9 female patients aged from 59 to 72 year old. The location of aneurysms was 3 basilar tip, 2 anterior communicating and 5 paraclinoid, 1 ICA, 1 vertebral artery. Complete and near complete aneurysm occlusion by angiogram was done, but 1 case required re?]embolization due to coil compaction. Percentage of volume occulsion was ranged from 17.05 to 31.9%. The clinical result of embolization treatment was good.

Conclusion : The use of new designed coils will enhance the ability to treat wide necked aneurysms with an endovascular approach. It is important to treat wide necked aneurysms that selection of initial coil to consider the coil features and aneurysmal factors and need for long term foloow up study.