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RETRACTED ARTICLE: Improved Endovascular Coiling of Wide-Neck Intracranial Aneurysms in Elderly Patients by Double-Microcatheter Technique

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This article was retracted on 22 January 2022

This article has been updated

Abstract

Elderly patients are more susceptible to intracranial aneurysms. However, many of them are poor surgical candidates and often have to undergo endovascular treatment. The purpose of this study was to evaluate the efficacy and safety of double-microcatheter technique as an alternative to a balloon- or stent-assisted techniques for wide-neck aneurysms in elderly patients. A retrospective review of 58 patients with 58 wide-neck aneurysms treated with the double-microcatheter technique between October 2010 and December 2012 was performed. Immediate post-embolization angiograms were evaluated using a conventional angiographic scale, and clinical evaluation was performed using the Glasgow Outcome Scale. Clinical and imaging follow-ups were available in 32 (55 %) patients, with a mean of 12.5 months. Post-embolization angiograms demonstrated total occlusion in 46 of 58 (79 %) aneurysms, a neck remnant in 7 (13 %), and body filling in 5 (8 %). The technique-related complication rate was 5 % (3/58), and the procedural-related mortality rate was 0. Of the 32 aneurysms with follow-ups, recanalization developed in 3 (9 %) aneurysms, and none received re-treatment. Using double-microcatheter technique for embolization of wide-neck intracranial aneurysms is safe and effective in the elderly patients. This technique is feasible and safe for coil embolization of wide-neck aneurysms, especially in cases, which are not suitable for balloon- or stent-assisted techniques.

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Abbreviations

GOS:

Glasgow outcome scale

3D:

Three dimensions

vPD:

Volumetric packing density

DSA:

Digital subtraction angiography

EVD:

External ventricular drain

PcomA:

Posterior communicating artery

DIND:

Delayed ischemic neurological deficits

SAH:

Subarachnoid hemorrhage

VP-shunt:

Ventriculoperitoneal shunt

3-H treatment:

Hypertension–hyperlipemia–hemodilution treatment

ICA:

Internal carotid artery

PCA:

Posterior carotid artery

References

  1. Benitez, R. P., Silva, M. T., Klem, J., Veznedaroglu, E., & Rosenwasser, R. H. (2004). Endovascular occlusion of wide-necked aneurysms with a new intracranial microstent (Neuroform) and detachable coils. Neurosurgery, 54, 1359–1368.

    Article  Google Scholar 

  2. Biondi, A., Janardhan, V., Katz, J. M., Salvaggio, K., Riina, H. A., & Gobin, Y. P. (2007). Neuroform stent-assisted coil embolization of wide-neck intracranial aneurysms: Strategies in stent deployment and midterm follow-up. Neurosurgery, 61, 460–469.

    Article  Google Scholar 

  3. Fiorella, D., Albuquerque, F. C., Han, P., & McDougall, C. G. (2004). Preliminary experience using the Neuroform stent for the treatment of cerebral aneurysms. Neurosurgery, 54, 6–16.

    Article  Google Scholar 

  4. Fujii, Y., Takeuchi, S., Sasaki, O., Minakawa, T., Koike, O., & Tanaka, R. (1997). Serial changes of hemostasis in aneurysmal subarachnoid hemorrhage with special reference to delayed ischemic neurological deficits. Journal of Neurosurgery, 86, 594–602.

    Article  CAS  Google Scholar 

  5. Jennett, B., Snoek, J., Bond, M. R., Spelle, L., & Moret, J. (1981). Disability after severe head injury: Observations on the use of the Glasgow Outcome Scale. Journal of Neurology, Neurosurgery and Psychiatry, 44, 285–293.

    Article  CAS  Google Scholar 

  6. Layton, K. F., Cloft, H. J., Gray, L. A., Lewis, D. A., & Kallmes, D. F. (2007). Balloon-assisted coiling of intracranial aneurysms: Evaluation of local thrombus formation and symptomatic thromboembolic complications. American Journal of Neuroradiology, 28, 1172–1175.

    Article  CAS  Google Scholar 

  7. Lee, J. Y., Seo, J. H., Cho, Y. D., Kang, H. S., & Han, M. H. (2011). Endovascular treatment of wide-neck intracranial aneurysms using a microcatheter protective technique: Results and outcomes in 75 aneurysms. American Journal of Neuroradiology, 32, 917–922.

    Article  CAS  Google Scholar 

  8. Molyneux, A. J., Kerr, R. S., Stratton, I., & International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. (2002). International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomized trial. Journal of stroke and cerebrovascular diseases, 11, 304–314.

    Article  Google Scholar 

  9. Molyneux, A. J., Kerr, R. S., Yu, L. M., & International Subarachnoid Aneurysm Trial (ISAT). (2005). International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: A randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet, 366, 809–817.

    Article  Google Scholar 

  10. Murayama, Y., Nien, Y. L., Duckwiler, G., Jahan, R., Frazee, J., et al. (2003). Guglielmi detachable coil embolization of cerebral aneurysms: 11 years’ experience. Journal of Neurosurgery, 98, 959–966.

    Article  Google Scholar 

  11. Piotin, M., Daghman, B., Mounayer, C., et al. (2006). Ellipsoid approximation versus 3D rotational angiography in the volumetric assessment of intracranial aneurysms. American Journal of Neuroradiology, 27, 839–842.

    CAS  PubMed  PubMed Central  Google Scholar 

  12. Ryttlefors, M., Enblad, P., Kerr, R. S., & Molyneux, A. J. (2008). International subarachnoid aneurysm trial of neurosurgical clipping versus endovascular coiling: Subgroup analysis of 278 elderly patients. Stroke, 39, 2720–2726.

    Article  Google Scholar 

  13. Shapiro, M., Babb, J., Becske, T., & Nelson, P. (2008). Safety and efficacy of adjunctive balloon remodeling during endovascular treatment of intracranial aneurysms: A literature review. American Journal of Neuroradiology, 29, 1777–1781.

    Article  CAS  Google Scholar 

  14. Sluzewski, M., van Rooij, W. J., Beute, G. N., & Nijssen, P. C. (2006). Balloon-assisted coil embolization of intracranial aneurysms: Incidence, complications, and angiography results. Journal of Neurosurgery, 105, 396–399.

    Article  Google Scholar 

  15. Taschner, C. A., Leclerc, X., Rachdi, H., Barros, A. M., & Pruvo, J. P. (2005). Matrix detachable coils for the endovascular treatment of intracranial aneurysms: Analysis of early angiographic and clinical outcomes. Stroke, 36, 2176–2180.

    Article  Google Scholar 

  16. Tumialan, L. M., Zhang, Y. J., Cawley, C. M., Dion, J. E., Tong, F. C., & Barrow, D. L. (2008). Intracranial hemorrhage associated with stent-assisted coil embolization of cerebral aneurysms: A cautionary report. Journal of Neurosurgery, 108, 1122–1129.

    Article  Google Scholar 

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Acknowledgments

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Correspondence to Xiang Xu.

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Xu, X., Zheng, Y., Wang, D. et al. RETRACTED ARTICLE: Improved Endovascular Coiling of Wide-Neck Intracranial Aneurysms in Elderly Patients by Double-Microcatheter Technique. Cell Biochem Biophys 71, 1281–1286 (2015). https://doi.org/10.1007/s12013-014-0344-3

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