Saccular Aneurysms of Cerebral Arteries
(Diagnosis and Endovascular Treatment)

Scheglov D.

Scientific practical Center of Endovascular Neurorentgenosurgery, Academy of Medical Sciences of Ukraine, Kiev, Ukraine

 

The research goal was to study results of endovascular treatment of cases with intracranial saccular aneurysms (SA) and their dependence on localization, size and anatomic peculiarities.

Material and Methods. There were 602 cases, aged 12-71, with SA of cerebral vessels, treated in the Science and Practice Center of Endovascular Neurosurgery (1998-2005). They were admitted in “cold” (437) and acute (165) periods of the disease. Distribution of aneurysms according to their size was as follows: up to 0.4 cm - 36, 0.4-0.6 cm - 218, 0.7-1.5 cm - 211, 1.6-2.5 cm - 110, 2.6 and more - 44 cases. Cerebral angiography (CAG) was a gold standard. Its data served the basis for choosing a method and technique of endovascular intervention. Angio-MRI, CT, SPECT and transcranial Doppler were used for examination of cerebral vessels and verification of angiospasm. Control CAG-examination was carried out 3 months, 6 months and a year after endovascular intervention. The majority of operations were performed with applying microballoon-catheters, developed in our center. We started to use GDC and MDC detachable coils in 2002 (21 cases).

Results. Operations (650) were made in 583 out of 602 cases. Complications developed in 58 patients (hemorrhage - 24, cerebral ischemia - 34). The mortality rate was 3.9% (23 cases; 18 - intra- or postoperative rupture of aneurysm, 5 - ischemia development). Repeated operations, caused by aneurysm relapse, were made in 67 cases.

Conclusion. Endovascular technology occupies a leading place in strategy of SA treatment and is irrespective of SA localization, size, a disease period, a patient’s state. It is not an alternative, but an operation of choice.