Publication: Impact of individual intracranial arterial aneurysm morphology on initial obliteration and recurrence rates of endovascular treatments: A multivariate analysis - Clinical article
Issued Date
2011-04-01
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ISSN
19330693
00223085
00223085
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2-s2.0-79953695391
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Mahidol University
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SCOPUS
Bibliographic Citation
Journal of Neurosurgery. Vol.114, No.4 (2011), 994-1002
Suggested Citation
Dittapong Songsaeng, Sasikhan Geibprasert, Karel G. Ter Brugge, Robert Willinsky, Michael Tymianski, Timo Krings Impact of individual intracranial arterial aneurysm morphology on initial obliteration and recurrence rates of endovascular treatments: A multivariate analysis - Clinical article. Journal of Neurosurgery. Vol.114, No.4 (2011), 994-1002. doi:10.3171/2010.8.JNS10241 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/12564
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Title
Impact of individual intracranial arterial aneurysm morphology on initial obliteration and recurrence rates of endovascular treatments: A multivariate analysis - Clinical article
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Abstract
Object. The goal was to investigate whether morphological features of aneurysms can be identified that determine initial success and recurrence rates of coiled aneurysms of the basilar artery tip, the posterior communicating artery (PCoA), and the anterior communicating artery. Methods. The authors evaluated 202 aneurysms in connection with their pretreatment morphological features including size, neck-to-dome ratio, angulation of the aneurysm in relation to the parent artery, orientation of the aneurysm dome, and associated anatomical variations. The mean follow-up was 19 months (range 6-96 months) after endovascular coil occlusion. Using multivariate logistic regression, probabilities for initial complete occlusion and long-term stability of the treatment were calculated. Results. Recanalization occurred in 49 of 202 cases. Favorable factors for long-term stability included small aneurysms with small necks. However, additional factors related to local hemodynamic forces could be identified for the different aneurysm locations, which may influence initial success rates and long-term stability of aneurysm treatment with endovascular coiling. These factors were a medial dome orientation and a symmetrical disposition of both A 1 segments (for the anterior communicating artery), a posteroinferior dome orientation and a small-size PCoA (for the PCoA), and a cranial symmetrical fusion (for the basilar artery tip). Conclusions. A detailed pretreatment analysis of morphological features of aneurysms may help to determine those aneurysms that are more prone to recurrence, which could add to the treatment decision and the follow-up algorithm. ©1944-2011 by the American Association of Neurosurgeons.