Immediate and long-term results of endovascular coiling of cerebral aneurysms
Abstract
This study is based on the immediate and long-term results of endovascular treatment of cerebral aneurysms by their occlusion with detachable coils. Based on the literature data, as well as our own clinical observations, conclusions have been drawn about the effectiveness of isolated occlusion of cerebral aneurysms by detachable coils.
PURPOSE OF THE STUDY. To evaluate the immediate and long-term angiographic results of endovascular occlusion of aneurysms by detachable coils.
MATERIAL AND METHODS. The analysis of the immediate and long-term angiographic results of endovascular occlusion of 64 cerebral aneurysms with detachable coils operated in the clinic in the period from 2013 to 2016 was performed. The study included 47 women and 13 men aged 18 to 72 years.
RESULTS. Our results indicate a high frequency (36.8 % after 6 months, 58.5 % after 12 months, 54.8 % after 36 months) of unstable occlusion of cerebral aneurysms when using detachable coils. Subtotal occlusion in our series turned out to be the most unstable type of occlusion (class II according to the Raymond-Roy classification), which demonstrated a stable result in each of the control points in the range from 7.3 % to 16.2 % (p<0.05). At the same time, there is a possibility of a delayed increase in the radicality of aneurysm occlusion (thrombosis) (23.6 % after 6 months, 26.8 % after 12 months, 32.3 % after 36 months) due to delayed thrombosis of the aneurysm sac. In addition, there is a fairly high frequency of recurrence formation (13.1 % after 6 months, 31.7 % after 12 months, 22.6 % after 36 months). The formation of relapses averaged 22.5 %.
CONCLUSION. The technique of endovascular coil occlusion of aneurysms can be a fairly effective method of treatment, allowing to achieve total occlusion of aneurysms, however, requires a more detailed study of the criteria for selecting patients for surgical intervention. According to our data, complete total occlusion of the aneurysm is possible only in 51.6 % of cases, which requires a more careful approach to the choice of this technique for the treatment of patients with cerebral aneurysms. The favorable characteristics of the aneurysm, contributing to its radical occlusion, are the size of the neck in the range from 3 to 6 mm and the usual size of the aneurysm (4–15 mm) (p<0,05).
About the Authors
V. V. Bobinov
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation
Russian Federation
Vasiliy Vital’evich Bobinov
St. Petersburg
L. V. Rozhchenko
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation
Russian Federation
Larisa Vital’evna Rozhchenko
St. Petersburg
S. A. Goroshchenko
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation
Russian Federation
Sergey Anatol’evich Goroshchenko
St. Petersburg
E. G. Kolomin
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation
Russian Federation
Egor Gennad’evich Kolomin
St. Petersburg
A. E. Petrov
“Polenov Neurosurgical Institute — branch of Almazov National Medical Research Centre”
Russian Federation
Russian Federation
Andrey Evgen’evich Petrov
St. Petersburg
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Review
For citations:
Bobinov V.V., Rozhchenko L.V., Goroshchenko S.A., Kolomin E.G., Petrov A.E. Immediate and long-term results of endovascular coiling of cerebral aneurysms. Russian Neurosurgical Journal named after Professor A. L. Polenov. 2022;14(2):29-36. (In Russ.)
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