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Endovascular coil embolization of middle cerebral artery aneurysms of the proximal (M1) segment

  • Interventional Neuroradiology
  • Published:
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Abstract

Introduction

Proximal middle cerebral artery (M1 segment) aneurysms have various configurations and are distinct from middle cerebral artery bifurcation aneurysms. We present the clinical and radiological results of coil embolization of the M1 segment aneurysms.

Methods

From a prospective database, we retrieved the data for 59 consecutive patients harboring 60 M1 aneurysms that were treated with endovascular coil embolization from January 2006 to May 2012. We assessed the clinical outcomes of the patients and morphological outcomes of the aneurysms using the Raymond classification.

Results

The aneurysms were located on the superior wall of the M1 segment in 43 and on the inferior wall in 17. Superior-wall aneurysms were related to the frontal cortical artery and the lateral lenticulostriate perforator while inferior-wall aneurysms were to the temporal cortical artery. With coil embolization, complete aneurysmal occlusion or residual neck could be achieved in 52 aneurysms (86.7 %) and residual aneurysm in 8. The microcatheter protection technique was most commonly used for coil embolization (41.7 %) followed by single microcatheter (31.7 %), double microcatheter (23.3 %), and stent protection (3.3 %). There was no procedure-related morbidity or mortality. Follow-up angiography more than 6 months after embolization (n = 46; mean 12.4 months) demonstrated stable occlusion in 40 (87.0 %), minor recanalization in 4 (8.7 %), and major recanalization in 2 (4.3 %). One patient experienced delayed cerebral infarction without permanent neurologic deficit.

Conclusion

Coil embolization in M1 aneurysms seems to be safe and efficacious, although it may require various technical strategies due to distinct anatomic configurations.

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Acknowledgement

This study was supported by a grant of the Korea Healthcare technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A111101).

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea

    Young Dae Cho, Woong Jae Lee, Kang Min Kim & Moon Hee Han

  2. Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongon-dong, Jongno-gu, Seoul, South Korea, 110-744

    Hyun-Seung Kang, Jeong Eun Kim & Moon Hee Han

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  1. Young Dae Cho
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  2. Woong Jae Lee
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  3. Kang Min Kim
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  4. Hyun-Seung Kang
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Correspondence to Hyun-Seung Kang.

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Cho, Y.D., Lee, W.J., Kim, K.M. et al. Endovascular coil embolization of middle cerebral artery aneurysms of the proximal (M1) segment. Neuroradiology 55, 1097–1102 (2013). https://doi.org/10.1007/s00234-013-1190-5

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  • DOI: https://doi.org/10.1007/s00234-013-1190-5

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