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العنوان
Endovascular treatment of intracranial aneurysms at bifurcation sites :
المؤلف
Mohamed, Ahmed Effat Abbas.
هيئة الاعداد
باحث / احمد عفت عباس محمد
مشرف / محمد سعد شھاب الد?ن
مشرف / ط?ل احمد ?وسف عامر
مشرف / محمد سع?د جمعة
مشرف / د?م?تر?س كلى لوب?ز
مناقش / محمد سعد شهاب الدين
مناقش / أحمد جمال عزب
مناقش / خالد محمد صبح عبدالمجيد
الموضوع
Bifurcation Aneurysm.
تاريخ النشر
2019.
عدد الصفحات
online resource (156 pages) :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
علم الأعصاب السريري
الناشر
تاريخ الإجازة
1/7/2019
مكان الإجازة
جامعة المنصورة - كلية الطب - طب المخ والأعصاب
الفهرس
Only 14 pages are availabe for public view

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Abstract

BACKGROUND AND PURPOSE: Endovascular coiling is widely used for treatment of both ruptured and unruptured aneurysms. Intracranial bifurcation aneurysms were classically considered unsuitable for endovascular treatment because of the risk of coil protrusion into the parent vessel. The introduction stent assisted coiling has allowed the bifurcation aneurysms to be endovascularly treated. The present study aims to evaluate the efficacy of the endovascular treatment of the intracranial bifurcation aneurysms METHODS: This study was conducted on 76 patients with radiologically documented intracranial aneurysms at bifurcation sites either ruptured (12 aneurysms) or unruptured (64 aneurysms). Endovascular coiling of intracranial aneurysms was done for all patients in our study aided in some with single or Y-configuration stenting. The radiological outcome was assessed immediately postoperative, and at follow-up at 6th, and 12th months with grading of the angiograms on the basis of modified 3-point Raymond scale.RESULTS: In terms of the Raymond grading (RG), the initial angiographic outcome was complete occlusion (RG1) in 45 aneurysms (59.2%), neck remnant (RG2) in 20 aneurysms (26.3%), and body filling (RG3) in 11 aneurysms (14.5%), while the final angiographic outcome at 1 year was RG1 in 55 aneurysms (72.4%), RG2 in 13 aneurysms (17.1%), and RG3 in 8 aneurysms (10.5%). Eleven aneurysms (14.5%) showed recanalization. The aneurysm size and the neck width were the statistically significant factors affecting the initial RG (P=0.0005, 0.001 respectively), final RG (P= 0.015, 0.012 respectively), and the recanalization rate (P= 0.012, 0.01 respectively).CONCLUSIONS: Endovascular treatment of intracranial aneurysms at bifurcation sites is safe and effective. Stent assisted coiling (SAC) has enabled us to offer a safe and effective endovascular treatment for bifurcation aneurysms by preventing coils herniation. Smaller aneurysm size and neck size are indicators of complete occlusion and lower recanalization rate.