Neurointervention.  2014 Sep;9(2):83-88. 10.5469/neuroint.2014.9.2.83.

Angiographic and Clinical Result of Endovascular Treatment in Paraclinoid Aneurysms

• Kwon WH
• Jeong HW
• Kim ST
• Seo JH

• KMID: 1910763
• DOI: http://doi.org/10.5469/neuroint.2014.9.2.83

Abstract

PURPOSE
The purpose of this study was to analyze the results of an immediate and mid-term angiographic and clinical follow-up of endovascular treatment for paraclinoid aneurysms.
MATERIALS AND METHODS
From January 2002 to December 2012, a total of 113 consecutive patients (mean age: 56.2 years) with 116 paraclinoid saccular aneurysms (ruptured or unruptured) were treated with endovascular coiling procedures. Clinical and angiographic outcomes were retrospectively evaluated.
RESULTS
Ninety-three patients (82.3%) were female. The mean size of the aneurysm was 5.5 mm, and 101 aneurysms (87.1%) had a wide neck. Immediate catheter angiography showed complete occlusion in 40 aneurysms (34.5%), remnant sac in 51 (43.9%), and remnant neck in 25 (21.6%). Follow-up angiographic studies were performed on 80 aneurysms (69%) at a mean period of 20.4 months. Compared with immediate angiographic results, follow-up angiograms showed no change in 38 aneurysms, improvement in 37 (Fig. 2), and recanalization in 5. There were 6 procedure-related complications (5.2%), with permanent morbidity in one patient.
CONCLUSION
Out study suggests that properly selected patients with paraclinoid aneurysms can be successfully treated by endovascular means.

Keyword

Paraclinoid aneurysm; Embolization; Angiographic follow-up

MeSH Terms

Aneurysm*
Angiography
Catheters
Female
Follow-Up Studies
Humans
Neck
Retrospective Studies

Figure

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  Fig. 1 A 49-year-old female with a ruptured paraclinoid aneurysm.A. The right internal carotid angiogram reveals a 8 mm-sized aneurysm with a wide neck (arrow) arising from the paraclinoid region. B. During embolization, the angiogram showed a thrombus (arrow) at the distal ACA and no contrast staining at its territories. C. After intra-arterial thrombolysis, the angiogram showed improvement in blood flow (arrow).

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  Fig. 2 A 47-year-old female with an unruptured paraclinoid aneurysm.A. The right internal carotid angiogram reveals a 4.1 mm-sized aneurysm with a wide neck (arrow) arising from the paraclinoid region. B. An immediate angiogram after stent-assisted coil embolization showed incomplete embolization with a remnant sac (arrow). C. A right carotid angiogram obtained 8 months after coiling showed complete obliteration of the remnant sac (arrow).

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  Fig. 3 A 67-year-old female with an unruptured paraclinoid aneurysm.A. The right internal carotid angiogram reveals a 5mm-sized aneurysm (arrow) arising from the paraclinoid region. B. An immediate angiogram after simple coil embolization showed a remnant neck (arrow). C. During the follow-up, there was a newly detected recurrence of an aneurysm (arrow) about 12 years after coiling. D. A right internal carotid angiogram showed complete obliteration of the recurrent aneurysm (arrow) using a stent-assisted coil technique.

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