Comparison of Long-Term Angiographic Results of Wide-Necked Intracranial Aneurysms : Endovascular Treatment with Single-Microcatheter Coiling, Double-Microcatheter Coiling, and Stent-Assisted Coiling
- Authors
- Hyun Sik Kim; Byung-Moon Cho; Chan Jong Yoo; Dae Han Choi; Dong Keun Hyun; Yu Shik Shim; Joon Ho Song; Jae Keun Oh; Jun Hyong Ahn; Ji Hee Kim; In Bok Chang
- Issue Date
- Sep-2021
- Publisher
- 대한신경외과학회
- Keywords
- Intracranial aneurysm; wide necked · Endovascular procedures · Embolization · Stent-assisted coiling
- Citation
- 대한신경외과학회지, v.64, no.5, pp.751 - 762
- Journal Title
- 대한신경외과학회지
- Volume
- 64
- Number
- 5
- Start Page
- 751
- End Page
- 762
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/82180
- DOI
- 10.3340/jkns.2021.0010
- ISSN
- 2005-3711
- Abstract
- Objective : Endovascular treatment of intracranial aneurysms is challenging in case of wide-necked aneurysms because coils are prone to herniate into the parent artery, causing thromboembolic events or vessel occlusion. This study aims to compare long-term angiographic results of wide-necked aneurysms treated by stent-assisted, double-microcatheter, or single-microcatheter groups.
Methods : Between January 2003 and October 2016, 108 aneurysms that were treated with endovascular coil embolization with a neck size wider than 4 mm and a follow-up period of more than 3 years were selected. We performed coil embolization with singlemicrocatheter, double-microcatheter, and stent-assisted techniques. Angiographic results were evaluated using the Raymond-Roy occlusion classification (RROC). All medical and angiographic records were reviewed retrospectively.
Results : Clinical and angiographic analyses were conducted in 108 wide-necked aneurysms. The immediate post-procedural results revealed RROC class I (complete occlusion) in 66 cases (61.1%), class II (residual neck) in 36 cases (33.3%), and class III (residual sac) in six cases (5.6%). The final follow-up results revealed class I in 48 cases (44.4%), class II in 49 cases (45.4%), and class III in 11 cases (10.2%). Of a total of 45 (41.6%) radiologic recurrences, there were 21 cases (19.4%) of major recurrence that required additional treatment, and 24 cases (22.2%) of minor recurrence. The final follow-up angiographic results showed statistically significant differences between the stent-assisted group and the others (p<0.01).
Conclusion : Long-term follow-up angiography demonstrated that the stent-assisted technique had a better complete occlusion rate than the other two techniques.
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