Endovascular Therapy Of Intracranial Wide-necked Aneurysms

OBJECTIVE To analyze the results of multiple endovascular techniques in treating intracranial wide-necked aneurysms and investigate the clinical applications of the techniques.MATERIALS AND METHODS From June 2007 to February 2010,38 intracranial wide-necked aneurysms underwent endovascular therapies in which 22 were treated by balloon-assisted coiling, stent-assisted coiling and double-microcatheter techniques (assisted coiling group), while the left 16 were treated by mere coils and nothing was applied to assist the coiling processes (simple coiling group). Characteristics and theraputic results of the aneurysms in the two groups were retrospectively analyzed.RESULTS There was no difference in aneurysm size and neck width between the two groups(P>0.05). A subgroup analysis was conducted in which aneurysms in both groups with a neck width≤4mm were erolled. The average sac-to-neck ratio was 1.09 (assisted coiling group) and 1.38 (simple coiling group) respectively (P<0.05). Among the 22 aneurysms treated by assisted techniques,16 were totally occluded,5 were subtotally occluded, and 1 was partially occluded, while in the other group 7 totally occluded,8 subtotally occluded, and 1 partially occluded. The total and subtotal occlusion rate was not significantly different between the two groups(P>0.05).3 patients in assisted coiling group were found to have intraoperative complications including thrombo formation and vasospasm, while 2 patients in simple coiling group experienced thrombo formation and parent atery occlusion. The incidence of operation related complications was not different between the two groups (P>0.05).CONCLUSION Assisted coiling techniques have greatly improve the endovascular theraputic effects of intracranial wide-necked aneurysms. Due to the application of new embolic materials, treatments of wide-necked aneurysms with mere coils without assisting tools have also got relatively satisfactory results. To get optimal effect, the choice of a specific method depends on the morphologic characteristics of an aneurysm as well as the patients'clinical condition.