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Endovascular coiling of proximal middle cerebral artery aneurysms: is it safe and durable?

  • Original Article - Vascular Neurosurgery - Aneurysm
  • Published:
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Abstract

Background

Proximal middle cerebral artery (M1 segment) aneurysms are relatively deeply located in neighboring lenticulostriate arteries, which make them unsuitable for microsurgery. We aimed to investigate the clinical and radiological outcomes of endovascular coiling of M1 segment aneurysms.

Methods

Between January 2003 and December 2014, we retrospectively reviewed the medical records of 52 patients (52 aneurysms) from four institutions who underwent endovascular coiling of M1 segment aneurysms. Patients who underwent clinical and radiologic follow-up for more than a year after the procedure were evaluated.

Results

The aneurysms were located in the early frontal branch, early temporal branch, and lenticulostriate artery in 28, 15, and nine patients, respectively. Endovascular coiling was achieved in 51 cases and failed in one case. Of these 51 cases, 46 (90.2%) and five (9.8%) were non-ruptured and ruptured aneurysms, respectively. Initial angiographic results revealed complete occlusion in 26 (51.0%), residual neck in 16 (31.4%), and residual sac in nine (17.6%) cases. One failed case had a symptomatic procedural complication of thromboembolism. However, there was no permanent morbidity or mortality. Two major recanalization cases (3.9%) were retreated by endovascular coiling. On multivariable logistic regression analysis, aneurysmal recurrence was significantly related to aneurysm height (OR, 1.887; 95% CI, 1.107 to 3.217; p = 0.020), width (OR, 1.836; CI, 1.127 to 2.992; p = 0.015), and neck (OR, 4.017; CI, 1.220 to 13.232, p = 0.022).

Conclusion

Endovascular coiling of M1 segment aneurysms appeared to be a feasible treatment option with a relatively low-retreatment rate. Aneurysm size was statistically significantly associated with recurrence.

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Abbreviations

DSA:

Digital subtraction angiography

GOS:

Glasgow Outcome Scale

MCA:

Middle cerebral artery

MRA:

Magnetic resonance angiography

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Authors and Affiliations

  1. Department of Radiology, Inje University Busan Paik Hospital, Busan, South Korea

    Jin Wook Baek, Young Jin Heo & Hae Woong Jeong

  2. Department of Neurosurgery, Dong-Eui Medical Center, Busan, South Korea

    Chae Wook Huh

  3. Department of Neurosurgery, Inje University Haeundae Paik Hospital, 1435 Jwa-dong Haeundae-gu, Busan, 612-043, Republic of Korea

    Min Wook Yoo & Sung-Chul Jin

  4. Department of Neurosurgery, Ulsan University Hospital, Ulsan, South Korea

    Soon Chan Kwon

  5. Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, South Korea

    O Ki Kwon

  6. Department of Neurosurgery, Inje University Busan Paik Hospital, Busan, South Korea

    Sung Tae Kim

Authors
  1. Jin Wook Baek
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  2. Chae Wook Huh
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  3. Young Jin Heo
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  4. Min Wook Yoo
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  5. Soon Chan Kwon
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  7. Hae Woong Jeong
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  8. Sung Tae Kim
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  9. Sung-Chul Jin
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Corresponding author

Correspondence to Sung-Chul Jin.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standard.

Informed consent

Informed consent was obtained from the study participants prior to their inclusion in the study.

Additional information

This article is part of the Topical Collection on Vascular Neurosurgery - Aneurysm

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Baek, J.W., Huh, C.W., Heo, Y.J. et al. Endovascular coiling of proximal middle cerebral artery aneurysms: is it safe and durable?. Acta Neurochir 160, 2411–2418 (2018). https://doi.org/10.1007/s00701-018-3707-5

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  • DOI: https://doi.org/10.1007/s00701-018-3707-5

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