Clinical Outcomes of Endovascular Coil Embolization for Paraclinoid Aneurysms

Jang, E Wook; Jung, Jin Young; Hong, Chang Ki; Suh, Sang Hyun; Joo, Jin Yang

Abstract

OBJECTIVE
Direct surgical clipping of paraclinoid aneurysms is challenging due to nearby anatomic structures. However, as endovascular techniques advance, endovascular coil embolizations for paraclinoid aneurysms are more frequently performed. We reviewed our experience with endovascular coil embolization of paraclinoid aneurysms to evaluate its safety and efficacy.
METHODS
From 2005 to 2011, 78 patients underwent endovascular procedures with detachable coils for 86 paraclinoid aneurysms at our institute. A retrospective review of the medical records was performed.
RESULTS
Seventy-eight patients with 86 paraclinoid aneurysms were evaluated. Thirteen patients (16.7%) were men and 65 (83.3%) were women. Patient age ranged from 23 to 78 years (mean age, 48 years). Five patients (6.4%) presented with subarachnoid hemorrhage (SAH) with decreased consciousness and visual field defects. In the 86 treated aneurysms, the immediate post procedural angiogram demonstrated complete occlusion in 73 aneurysms (84.9%), near-complete occlusion in eight aneurysms (9.3%) and partial occlusion in five aneurysms (5.8%). We obtained angiographic follow-up in 46 cases. Minor recanalization occurred in two cases and major recanalization occurred in one case. One thromboembolic complication and one blurred vision occurred among the 78 patients.
CONCLUSION
Despite difficulties with surgical approaches for paraclinoid aneurysms, these lesions can be successfully managed by endovascular treatment. Favorable outcomes with a low morbidity suggest endovascular techniques as alternatives to microsurgical therapy for treating paraclinoid aneurysms.