Coil Embolization of Cerebral Tiny Aneurysms

Purpose: We retrospectively examined the results of coil embolization for 28 cerebral tiny aneurysms (<3 mm), 73 small cerebral aneurysms (3–4 mm) and associated complications.Subjects and Methods: From a total of 418 patients who underwent coil embolization of cerebral aneurysms (n = 433) betwee...

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Published inJournal of Neuroendovascular Therapy Vol. 10; no. 5; pp. 243 - 248
Main Authors Yagi, Ryokichi, Kimura, Seigo, Yamashita, Taro, Hiramatsu, Ryo, Yamada, Makoto, Kuroiwa, Terumasa, Yamada, Yoshitaka, Shimizu, Fuminori
Format Journal Article
LanguageEnglish
Published The Japanese Society for Neuroendovascular Therapy 2016
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ISSN1882-4072
2186-2494
DOI10.5797/jnet.oa.2016-0035

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Abstract Purpose: We retrospectively examined the results of coil embolization for 28 cerebral tiny aneurysms (<3 mm), 73 small cerebral aneurysms (3–4 mm) and associated complications.Subjects and Methods: From a total of 418 patients who underwent coil embolization of cerebral aneurysms (n = 433) between January 2008 and August 2015, we analyzed 28 cerebral tiny aneurysms (6.5%) and 73 small aneurysms (16.9%). The type of procedure, results of embolization, and complications were compared.Results: For 23 (82.1%) of the 28 tiny aneurysms and 52 (71.2%) of the 73 small aneurysms, embolization was performed using a simple technique. Embolization resulted in complete obliteration (CO) and neck remnant (NR) in 26 (92.9%) of the 28 tiny aneurysms, and CO + NR was achieved in 62 (84.9%) of the 73 small aneurysms. Treatment was discontinued for one tiny aneurysm and one small aneurysm. Intraoperative rupture occurred in one tiny aneurysm and three small aneurysms. Thromboembolism was observed in one tiny aneurysm and one small aneurysm. Morbidity was encountered in one tiny aneurysm (thromboembolism), and mortality was associated with another tiny aneurysm (intraoperative rupture).Conclusion: The results of coil embolization for tiny aneurysms were similar to those of small aneurysms. Coil embolization-related complications and prognosis were also considered to be similar.
AbstractList Purpose: We retrospectively examined the results of coil embolization for 28 cerebral tiny aneurysms (<3 mm), 73 small cerebral aneurysms (3–4 mm) and associated complications.Subjects and Methods: From a total of 418 patients who underwent coil embolization of cerebral aneurysms (n = 433) between January 2008 and August 2015, we analyzed 28 cerebral tiny aneurysms (6.5%) and 73 small aneurysms (16.9%). The type of procedure, results of embolization, and complications were compared.Results: For 23 (82.1%) of the 28 tiny aneurysms and 52 (71.2%) of the 73 small aneurysms, embolization was performed using a simple technique. Embolization resulted in complete obliteration (CO) and neck remnant (NR) in 26 (92.9%) of the 28 tiny aneurysms, and CO + NR was achieved in 62 (84.9%) of the 73 small aneurysms. Treatment was discontinued for one tiny aneurysm and one small aneurysm. Intraoperative rupture occurred in one tiny aneurysm and three small aneurysms. Thromboembolism was observed in one tiny aneurysm and one small aneurysm. Morbidity was encountered in one tiny aneurysm (thromboembolism), and mortality was associated with another tiny aneurysm (intraoperative rupture).Conclusion: The results of coil embolization for tiny aneurysms were similar to those of small aneurysms. Coil embolization-related complications and prognosis were also considered to be similar.
Author Shimizu, Fuminori
Yamashita, Taro
Yamada, Makoto
Yamada, Yoshitaka
Yagi, Ryokichi
Kimura, Seigo
Hiramatsu, Ryo
Kuroiwa, Terumasa
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  organization: Department of Neurosurgery and Neuroendovascular Therapy, Osaka Medical College, Osaka, Japan
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  fullname: Kimura, Seigo
  organization: Department of Neurosurgery, Kozenkai Yagi Neurosurgical Hospital, Osaka, Japan
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  fullname: Yamashita, Taro
  organization: Department of Neurosurgery, Seijinkai Shimizu Hospital, Osaka, Japan
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  fullname: Yamada, Makoto
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  fullname: Kuroiwa, Terumasa
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  fullname: Yamada, Yoshitaka
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  organization: Department of Neurosurgery, Seijinkai Shimizu Hospital, Osaka, Japan
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Cites_doi 10.3171/JNS/2008/108/6/1088
10.5797/jnet.4.99
10.2176/nmc.oa.2013-0228
10.1161/STROKEAHA.109.566356
10.1177/159101991001600401
10.1007/s00234-008-0371-0
10.3174/ajnr.A1429
10.3174/ajnr.A1374
10.2335/scs.41.110
10.1136/neurintsurg-2012-010537
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2) van Rooij WJ, Keeren GJ, Peluso JP, et al: Clinical and angiographic results of coiling of 196 very small (< or = 3 mm) intracranial aneurysms. AJNR Am J Neuroradiol 2009; 30: 835–839.
6) Imamura H, Sakai N, Sakai C, et al: Endovascular treatment of aneurysmal subarachnoid hemorrhage in Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2. Neurol Med Chir (Tokyo) 2014; 54: 81–90.
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References_xml – reference: 5) Ohshima K, Terada T, Hiyama T, et al: Hemorrhagic complications of endovascular coil embolization for very small intracranial aneurysms. Surg Cerebral Stroke 2013; 41: 110–115. (in Japanese)
– reference: 1) Brinjikji W, Lanzino G, Cloft HJ, et al: Endovascular treatment of very small (3 mm or smaller) intracranial aneurysms: report of a consecutive series and a meta-analysis. Stroke 2010; 41: 116–121.
– reference: 4) Tsutsumi M, Aikawa H, Onizuka M, et al: Endovascular treatment of tiny ruptured anterior communicating artery aneurysms. Neuroradiology 2008; 50: 509–515.
– reference: 7) Starke RM, Chalouhi N, Ali MS, et al: Endovascular treatment of very small ruptured intracranial aneurysms: complications, occlusion rates and prediction of outcome. J Neurointerv Surg 2013; 5: iii66–iii71.
– reference: 10) Gupta V, Chugh M, Jha AN, et al: Coil embolization of very small (2 mm or smaller) berry aneurysms: feasibility and technical issues. AJNR Am J Neuroradiol 2009; 30: 308–314.
– reference: 2) van Rooij WJ, Keeren GJ, Peluso JP, et al: Clinical and angiographic results of coiling of 196 very small (< or = 3 mm) intracranial aneurysms. AJNR Am J Neuroradiol 2009; 30: 835–839.
– reference: 9) Miyachi S, Izumi T, Matsubara N, et al: The mechanism of catheter kickback in the final stage of coil embolization for aneurysms: the straightening phenomenon. Interv Neuroradiol 2010; 16: 353–360.
– reference: 6) Imamura H, Sakai N, Sakai C, et al: Endovascular treatment of aneurysmal subarachnoid hemorrhage in Japanese Registry of Neuroendovascular Therapy (JR-NET) 1 and 2. Neurol Med Chir (Tokyo) 2014; 54: 81–90.
– reference: 8) Nguyen TN, Raymond J, Guilbert F, et al: Association of endovascular therapy of very small ruptured aneurysms with higher rates of procedure-related rupture. J Neurosurg 2008; 108: 1088–1092.
– reference: 3) Yamaura I, Uramoto S, Kidera M, et al: Coil embolization of small aneurysms with a maximum diameter of 3mm. JNET 2010; 4: 99–105. (in Japanese)
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  doi: 10.3171/JNS/2008/108/6/1088
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  doi: 10.5797/jnet.4.99
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  doi: 10.2176/nmc.oa.2013-0228
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  doi: 10.1161/STROKEAHA.109.566356
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  doi: 10.1177/159101991001600401
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  doi: 10.1007/s00234-008-0371-0
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  doi: 10.3174/ajnr.A1429
– ident: 10
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  doi: 10.2335/scs.41.110
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  doi: 10.1136/neurintsurg-2012-010537
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SubjectTerms coil embolization
small cerebral aneurysm
tiny cerebral aneurysm
Title Coil Embolization of Cerebral Tiny Aneurysms
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