Favorable outcome of endovascular treatment for intracranial aneurysms: A single-center study in Thailand

• Published in: Asian journal of neurosurgery 2018-07, Vol.13 (3), p.721-729
• Main Authors: Withayasuk, Pattarawit, Churojana, Anchalee, Songsaeng, Dittapong, Aurboonyawat, Taweesak, Chankaew, Ekawut
• Format: Article
• Language: English
• Subjects: Angiography; Care and treatment; Cerebral aneurysm; Complications and side effects; Original; Original Article; Patient outcomes; Vascular surgery
• ISSN: 1793-5482; 2248-9614
• DOI: 10.4103/ajns.AJNS_70_18

Purpose: The purpose of this study is to collect the information on patients with intracranial aneurysm (IA) receiving endovascular management in Siriraj Hospital, Mahidol University, Thailand. Materials and Methods: We retrospectively reviewed data from patients with IA who underwent endovascular treatment from January 1997 through July 2013. We collected patients' demographic data including age, sex, clinical presentations, and aneurysmal profiles, as well as endovascular treatment technique, complications, angiographic results, and regrowth rate. Treatment results included success rate, clinical findings during follow-up, and regrowth rate. Results: We reviewed data from 497 patients with 636 aneurysms (female:male ratio, 1.9:1; age range, 15–90 years; mean age, 59.18 years) and 69% presented with rupture. One hundred and twenty patients with 127 aneurysms received endovascular treatment. The most common location for endovascular treatment was the posterior communicating artery (15.8%), and endovascular techniques were used most often for posterior circulation and paraclinoid aneurysms. The success rate was approximately 99.2% with a 16.5% regrowth rate and no rebleeding. Regrowth rate did not correlate with immediate postoperative angiographic findings. We encountered 23 complications (18.1%); most commonly, intra-procedural rupture (7/23). Good outcomes occurred in approximately 95.9% of the patients. Conclusions: The success rate for endovascular treatment was >90%. Regrowth rate and clinical outcomes were within standard limits. Posterior circulation and paraclinoid aneurysms were our main targets. We tended to use fewer devices and simpler techniques to secure ruptured IA; however, the regrowth rate was similar to that using device-assisted techniques in other studies. We found no significant factors affecting regrowth rate, including immediate posttreatment angiographic results.