Because of the risk of intraoperative rupture and technical difficulties, coil embolization of very small aneurysms (VSIAs) with a diameter of ≤3 mm is challenging. Herein, we reviewed our treatment strategies and outcomes in performing coil embolization for VSIAs compared to those for larger sized intracranial aneurysms (IAs) with 4 to 4.5 mm. We retrospectively reviewed the data on ruptured and unruptured VSIAs and larger-sized IAs treated with coiling from January 2012 to June 2021. Saccular IAs treated with coil embolization and followed up for at least 6 months with imaging studies were included in the study. Fifty-eight VSIAs (27 subarachnoid hemorrhages [SAH group] and 31 unruptured hemorrhages [URA group]) were identified. The wide-necked VSIAs were significantly more common in the URA group (90.3% vs 63.0%, P = .013). Procedural complications occurred in 8 cases (13.8%): intra-procedural rupture (n = 3), coil prolapse (n = 3), and thromboembolic events (n = 2). Complications were more frequent in the SAH group (P = .020). SAH was an independent risk factor for procedural complications (odds ratio, 11.293 [95% confidence interval: 1.173-108.684], P = .036), and the outcomes were affected by SAH presentation (P = .007) and poor clinical status of SAH (P = .001). When compared with larger IAs (n = 57), there were no significant differences in treatment outcomes, procedural complications, and clinical outcomes. VSIAs ≤ 3 mm in diameter were successfully treated with coil embolization, with reasonable procedure-related complications and treatment outcomes. The safety and efficacy of coil embolization for VSIAs were comparable to those of 4 to 4.5 mm sized IAs in this single-center cohort.
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http://dx.doi.org/10.1097/MD.0000000000034493 | DOI Listing |
Interv Neuroradiol
December 2024
Department of Neurosurgery, Clinical Neuroscience Center, University of Utah, Salt Lake City, UT, USA.
Background: The integration of robotics into neuroendovascular surgery has the potential to revolutionize the field by enhancing precision, reducing procedure-related risks, and improving patient outcomes. The CorPath GRX system represents a significant advancement in this domain. In this systematically conducted scoping review, we explore the current applications, advances, and challenges associated with robot-assisted neuroendovascular surgery.
View Article and Find Full Text PDFJ Neurosurg
December 2024
Departments of1Neurological Surgery.
Objective: Endovascular intracranial aneurysm (IA) management has significantly evolved over the last 2 decades. Despite these advancements, the aneurysm recanalization rate after coil embolization remains a concern. Statins have been found to affect vascular repair and remodeling; therefore, the authors hypothesized that patients receiving statin therapy at the time of coil embolization would have lower aneurysm recurrence and retreatment rates compared with patients not receiving statin therapy.
View Article and Find Full Text PDFMedicine (Baltimore)
December 2024
Department of Hepatobiliary Pancreatic Surgery, Ehime University Graduate School of Medicine, Toon City, Ehime, Japan.
Rationale: Pseudoaneurysm is a potential postoperative complication in hepatobiliary and pancreatic surgery, with catheter-based interventions being the first-line treatment. This study reviews the literature on potential secondary complications following arterial embolization. Additionally, we report a case in which a dislodged embolization coil acted as a nidus for bile duct stone formation, leading to recurrent cholangitis.
View Article and Find Full Text PDFInterv Neuroradiol
December 2024
Department of Neuroradiology, Beaumont Hospital, Dublin, Ireland.
Purpose: Intraprocedural complications during intracranial embolisation include thromboembolic vessel occlusion, catheter tip detachment and coil migration. Stentrievers and aspiration catheters are valuable devices for the management of these complications. We present our experience with the use of these devices.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
February 2025
Department of Vascular and Endovascular Surgery, University of California at San Diego, San Diego, CA.
Superior mesenteric artery (SMA) pseudoaneurysm with superior mesenteric arteriovenous fistula (SMAVF) is a rare pathology associated with high rates of rupture and mortality. Known interventions for the treatment of SMA pseudoaneurysm with SMAVF include open repair or endovascular repair with coil embolization or covered stenting. To the best of our knowledge, this report is the first of physician-modified endograft for the treatment of SMA pseudoaneurysm with SMAVF after prior thrombosis, ligation, and coil embolization of the SMA.
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