The role of coil packing density in stable occlusion of intracranial aneurysms treated with balloon or stent-assistance

Year 2020, Volume: 45 Issue: 2, 408 - 413, 30.06.2020

Yılmaz Önal , Murat Velioğlu

https://doi.org/10.17826/cumj.689986

Abstract

Purpose: Many studies are showing that coil package density (CPD) is an important predictive factor in intracranial aneurysm recurrence. In this study, we aimed to show the role of CPD in aneurysm stable occlusion according to the endovascular technique used in the treatment.
Materials and Methods: Retrospective analysis of 31 intracranial aneurysms in 30 patients treated with the balloon or stent-assisted coil embolization was made between 2018-2019. After the treatment, Raymond-Roy classification was used for aneurysm occlusion assessment. AngioCalc cerebral and peripheral aneurysm calculator was used for the assess packing density of the treated aneurysms.
Results: Thirty-one intracerebral aneurysms in 30 patients were included in the study. The number of aneurysms with balloon-assisted coil embolization was 18, while the number of aneurysms with stent-assisted embolization was 13. Recanalization was detected in the control image of 38.8% of patients in the balloon group and 7.7% of patients in the stent group. In our study, mortality was not observed, and the morbidity rate was 3.3%.
Conclusion: CPD is a significant factor in providing Raymond-Roy Class 1 aneurysm occlusion. However, as the aneurysm volume increases in size, it becomes difficult to achieve high CPD, which increases the risk of recanalization. Studies with a larger patient group could show that the use of stents reduces the risk of recurrence in aneurysms treated with stent assistance.

Keywords

ntracranial aneurysm, coil, coil package density, embolization

Balon ya da stent yardımlı intrakranial anevrizma tedavisi stabil okluzyonunda koil paket dansitesinin rolü

Abstract

Amaç: Koil paket dansitesinin (KPD) intraktaniyal anevrizma nüksünde önemli bir prediktif faktör olduğu ile ilgili birçok çalışma vardır. Çalışmamızda KPD yoğunluğunun tedavide kullanılan endovasküler tekniğe göre, anevrizma stabil okluzyonundaki rolünü göstermeyi amaçladık.

Gereç ve Yöntem: 2018-2019 tarihleri arasında balon ya da stent yardımlı koil embolizasyon ile tedavi edilmiş anevrizmaların retrospektif analizi yapıldı. Tedavi sonrası anevrizma okluzyon değerlendirmesinde Raymond-Roy sınıflaması, anevrizmaların paketleme yoğunluğu için ise AngioCalc serebral ve periferik anevrizma hesaplayıcısı kullanıldı.

Bulgular: Çalışmaya 30 hastadaki 31intraserebral anevrizma dahil edildi. Balon yardımlı koil embolizasyon yapılan anevrizma sayısı 18 iken, stent yardımlı embolizasyon yapılan anevrizma sayısı ise 13 idi. Yapılan kontrol görüntülemede balon yardımı kullanılan hastaların %38.8’inde, stent yardımı kullanılan hastaların ise %7.7’sinde rekanalizasyon saptandı. Çalışmamızda mortalite izlenmemiş olup, morbidite oranı %3.3 idi. 

Sonuç: KPD yoğunluğu, Raymond-Roy Class 1 anevrizma okluzyonu sağlamak için oldukça önemli bir faktördür. Bununla birlikte, anevrizma hacmi arttıkça, yüksek KPD sağlamak zorlaşmakta ve bu durum rekanalizasyon riskini arttırmaktadır. Daha büyük hasta grupları ve daha uzun süreli takipler ile yapılacak çalışmalar, stent yardımlı tedavi edilen anevrizmalarda, stent kullanımının da nüks riskini azalttığını gösterilebilir.

Keywords

İntrakranial anevrizma, koil, koil paket dansitesi, embolizasyon

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