Save
Endovascular treatment of complex MCA aneurysms
EANS Academy. Kiselev V. 09/25/19; 275629; EP01008
Vitaly Kiselev
Vitaly Kiselev

Access to this content is reserved for EANS members and attendees of this event. Click here to become an EANS member and gain your access to the full content of the EANS Academy


Abstract
Discussion Forum (0)
Rate & Comment (0)
Introduction: Endovascular therapy of intracranial aneurysms is rapidly undergoing major developments. With increasing experience and development of appropriate devices the indications for endovascular aneurysm therapy have considerably widened.The middle cerebral artery (MCA) is a very common site for aneurysm formation. MCA aneurysms represent 18% to 40% of all intracranial aneurysms. Although MCA aneurysms are easily accessed in the surgical clipping approach, MCA bifurcation location is often considered for endovascular treatment.
Materials and methods: For the period from 05.2014 to 12.2018 inclusive, in the department of vascular neurosurgery, endovascular operations on MCA aneurysms were performed in 23 patients. The mean age was 50,2 years. Men were 10 (43%), women - 13 (57%). Most aneurysms were located at M1 segment 10 (43,5%). 8 (34,8%) of the aneurysms were at MCA bifurcation and 5 (21,7%) at distal part of the artery. Saccular aneurysms were 19 (82,7%), fusiform - 4 (17,3%).Immediate and 6-months angiographic results were evaluated by Raymond-Roy Scale. To assess clinical outcome, we applied modified Rankin scale (mRs)..
Results: A total 23 endovascular procedures were performed. Coiling we used in 1 (4,4%) patients, coiling with stent-assistance - 14 (60,9%) or with balloon-assistance - 3 (13%) and in 5 (21,7%) cases we deployed flow-diverters (FD). Following types of stenting techniques were used: single stent was used in 4 (28,6%) cases, Y-stenting in 8 (57,1%) patients and telescopic stenting - 2 (14,3%) case. Immediate complete occlusion rate (Raymond I) was achieved in 16 (88,8%), near complete (Raymond II) in 2 (11,2%) aneurysms. We excluded FD from the immediate result evaluation. Complications leading to permanent morbidity in 1 patient (4,3%). Good clinical result (mRs 0-2) has been got in 22 (95,7%).
Conclusion: Endovascular treatment of MCA aneurysms is effective and can be performed with acceptable morbidity in selected patients.
Code of conduct/disclaimer available in General Terms & Conditions
Anonymous User Privacy Preferences

Strictly Necessary Cookies (Always Active)

MULTILEARNING platforms and tools hereinafter referred as “MLG SOFTWARE” are provided to you as pure educational platforms/services requiring cookies to operate. In the case of the MLG SOFTWARE, cookies are essential for the Platform to function properly for the provision of education. If these cookies are disabled, a large subset of the functionality provided by the Platform will either be unavailable or cease to work as expected. The MLG SOFTWARE do not capture non-essential activities such as menu items and listings you click on or pages viewed.


Performance Cookies

Performance cookies are used to analyse how visitors use a website in order to provide a better user experience.



Google Analytics is used for user behavior tracking/reporting. Google Analytics works in parallel and independently from MLG’s features. Google Analytics relies on cookies and these cookies can be used by Google to track users across different platforms/services.


Save Settings