Endovascular treatment of intracranial vertebral artery dissecting aneurysm, a case series study with two years follow up on complications
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This study is aimed to analyze the clinical outcomes of endovascular treatments for patients with intracranial vertebral artery dissecting aneurysms.Clinical data of 32 patients with vertebral artery dissecting aneurysms who underwent endovascular procedures in the Department of Neurosurgery of our University from January 2016 to December 2019 were retrospectively analyzed. Nine cases were treated with endovascular occlusion; 23 cases received reconstructive treatment, including 20 cases of stent combined with coil embolization, and 3 cases of stent implantation. The angiography taken at 3-22 months after surgery was reviewed.The endovascular treatments for all 32 cases were successful. Thirty-one cases had no postoperative complications during index hospital. Mid-term follow-up showed that: 27 cases (84%) had embolism; 5 cases (16%) had recurrence, of which 4 cases were treated again with endovascular procedures followed with no further complications and no recurrence, and 1 case received closely monitor but no reoperation. During an average follow-up of 10.5 months, except for one case that was self-discharged due to end-stage brainstem compression and respiratory failure, the rest of the patients were in stable conditions without bleeding or infarction.Endovascular treatment of intracranial vertebral artery dissecting aneurysms is safe and effective. Recurrent vertebral artery dissecting aneurysms can be treated with endovascular reoperations with satisfactory outcomes.Objective To evaluate the treatment of aneurysms rupture during endovascular embolization.Methods Nine aneurysms ruptured during the embolization and were treated with endovascular embolization.The reasons of aneurysms rupture during embolization,the prevention and the first aid after aneurysms rupture were analysed.Results Seven patients recovered and 2 died.Conclusions The optimal treatment of aneurysms rupture during endovascular embolization is effective,(J Intervent Radiol,2007,16: 132-134)
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NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY OPEN CNS.ORG NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY OPEN CNS.ORG
Pediatric neurosurgery
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The purpose of our study was to evaluate the outcomes of neurosurgical and endovascular treatment of ruptured intracranial aneurysms over a lifetime, based on the results of the International Subarachnoid Aneurysm Trial. We performed a decision analysis, using a Markov model, to evaluate outcomes of neurosurgical and endovascular treatment of ruptured intracranial aneurysms that were suitable for both treatments over a lifetime. We chose 50 years as cohort age. Effectiveness was measured in quality-adjusted life-years (QALYs). In addition, we calculated life expectancy and subarachnoid haemorrhage (SAH)-related mortality and disability rates. Compared with neurosurgery, endovascular treatment increased effectiveness by 1.0 QALY (neurosurgery, 13.1 QALYs; endovascular treatment, 14.1 QALYs) and life expectancy by 0.7 years (neurosurgery, 23.2 years; endovascular treatment, 23.9 years), and decreased SAH-related mortality by 0.4% (neurosurgery, 11.5%; endovascular treatment, 11.1%) and SAH-related disability by 5.0% (neurosurgery, 21.3%; endovascular treatment, 16.3%). One-way sensitivity analysis showed that no parameters influenced the effectiveness of endovascular treatment compared with neurosurgery. For ruptured intracranial aneurysms suitable to both neurosurgical and endovascular treatment, endovascular treatment is more effective than neurosurgery over a lifetime.
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NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY PRACTICE CNS.ORG NEUROSURGERY PUBLICATIONS NEUROSURGERY OPERATIVE NEUROSURGERY NEUROSURGERY PRACTICE CNS.ORG
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Objective To explore the techniques and curative effects of endovascular embolization of ruptured intracraniala neurysms with detachable coils on them. Methods The endovascular embolization was performed in 141 patients with rupturedi ntracranial aneurysms, of whom, 86 received endovascular embolization only with the detachable coils, 24 with the balloons andd etachable coils, and 31 with the stents and detachable coils. Results Of 141 aneurysms, 93 were embolized by 100 %, 31 by 95 %, 10b y 90 %, 5 by less than 90% and 2 were unsuccessfully embolized. Three aneurysms ruptured again during the endovascular treatment.O f 141 patients, 107 were recovered well, 24 mildly disabled, 7 severly disabled and 3 patients died after the embolization. Of 127p atients followed up from 3 to 33 months, all the patients had no rebleeding and 7 had recurrent aneurysms. Conclusions Thee ndovascular embolization with detachable coils is a safe and effective method to treat the ruptured intracranial aneurysms. The deadr ate and disabled rate may be decreased by the early endovascular embolization and positive post-operative treatment in the patientsw ith ruptured intracranial aneurysms.
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Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
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Objective To find out the clinical significance of endovascular embolization in the treatment of cerebral arteriovenous malformation (AVM). Methods Clinically 37 patients were treated by endovascular embolization with NBCA and/or ONYX as embolic materials, followed by γ-knife therapy in 11 patients of them. Results After endovascular embolization, anatomical cure was achieved in 6 cases, more than 90% disappearance of the malformations in size in 11 cases, 70%~90% disappearance in 17 and less than 70% disappearance in 3. 2 cases of the group appeared periusion pressure-induced cerebral swelling, and other 2 cases suffered from hemorrhage after embolization. Conclusion Endovascular embolization is a safe and reliable method for treating AVM. In regard to some large AVMs or ones situated at important functional areas, endovascular embolization combined with surgery or γ- knife is an effective method for AVM with a high cure rate and a low morbiditv and mortalitv.
Arteriovenous malformation
Cure rate
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