Abstract
Introduction
The aim of this study was to evaluate the feasibility of endovascular treatment (EVT) for ruptured very small (≤5 mm) or tiny (≤3 mm) paraclinoid aneurysms of the internal carotid artery (ICA).
Methods
From November 2009 to April 2012, 32 ruptured paraclinoid aneurysms (very small, 23; tiny, 9) in 31 patients received EVT. Angiographic follow-up determined occlusion rates which were classified as total/near-total (95–100 %), subtotal (80–95 %), and partial (<80 %) occlusions. Follow-up data were retrospectively analyzed and categorized using the Modified Rankin Scale (mRS).
Results
Based on our paraclinoid aneurysm classification, 25 % (8) were classified as type I, 46.9 % (15) as type II, and 28.1 % (9) as type III. EVT was technically successful in 96.8 % (31), with coiling only in 12.5 % (4), balloon remolding coiling in 6.3 % (2), and stent-assisted coiling in 78.1 % (25). Total/near-total occlusion was immediately achieved in 34.4 % (11), subtotal occlusion in 37.5 % (12), and partial occlusion in 28.1 % (9). Follow-up angiography (mean, 9.9 ± 6.4 months) revealed total/near-total occlusion in 50 % (16) aneurysms, subtotal in 31.3 % (10), and partial occlusion in 18.8 % (6). At the end of clinical follow-up (mean, 14.8 ± 9.5 months), it revealed an mRS grade 0 in 38.7 % (12) of patients, grade 1 in 25.8 % (8), grade 2 in 22.6 % (7), grade 3 in 6.5 % (2), grade 4 in 3.2 % (1), and grade 5 in 3.2 % (1).
Conclusion
EVT is feasible and effective for ruptured very small or tiny paraclinoid aneurysms of the ICA.
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Abbreviations
- EVT:
-
Endovascular treatment
- mRS:
-
Modified Rankin Scale
- PComA:
-
Posterior communicating artery
- ICA:
-
Internal carotid artery
- SAH:
-
Subarachnoid hemorrhage
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Xu, J., Chen, XY., Jiang, DY. et al. The feasibility and efficacy of endovascular treatment for very small or tiny ruptured paraclinoid aneurysms. Neuroradiology 55, 77–83 (2013). https://doi.org/10.1007/s00234-012-1080-2
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DOI: https://doi.org/10.1007/s00234-012-1080-2