Rüptüre Olmamış İntrakranyal Anevrizmalarda Endovasküler Tedavi Yaklaşımları: Tek Merkezli Çalışma

Abstract

Amaç: İntrakranyal rüptüre olmamış anevrizmalarda tam tedavi endikasyonları ve optimal tedavi stratejileri tartışmalıdır.

Materyal-Metod: Bu çalışmada, tek bir merkezde farklı endovasküler tekniklerle tedavi edilen rüptüre olmamış anevrizma hastalarındaki sonuçlarımızı sunuyoruz. Nisan 2008 - Ekim 2014 tarihleri arasında, 100 ardışık hastada 106 adet rüptüre olmamış anevrizma, merkezimizde farklı endovasküler teknikler ile tedavi edildi. Çalışmada ortalama yaşı 53.2 yıl olup 15-76 yıl arasında dağılım gösteren 35 erkek 65 kadın hasta vardı. Anevrizmaların yeri, tipi, kompleksitesi ve büyüklüğüne göre endovasküler primer koilleme, balon veya stent yardımlı koilleme, intrasakküler akım yönlendiriciler veya parent arter oklüzyonu yapıldı.

Bulgular: 6 aylık izlemde 101 anevrizmada (% 100) tam oklüzyon ve 5 anevrizmada (% 90 -% 100) ise tama yakın oklüzyon sağlandı. Dört hastanın 2'sinde tromboemboli ve 2 hastada ise işlem sırasında anevrizma perforasyonu gibi prosedürle ilgili komplikasyonlar oldu. Takip görüntüleme 61 hastada anjiografi ile, 16 hastada BT anjiyografi ve 23 hastada MR anjiyografi ile yapıldı. Ortalama izlem zamanı 10.05 ay (6-50 ay) idi.

Sonuç: Rüptüre olmamış intrakranyal anevrizmaların endovasküler tedavisi, seçilmiş hastalarda risk-fayda analizine göre güvenli bir yöntem gibi gözükmektedir.

Keywords

• Rüptüre olmamış intrakranyal anevrizmalar,Endovasküler Teknikler,Embolizasyon

Endovascular Management of Unruptured Intracranial Aneurysms: Single-Center Report

Abstract

Objective: The exact treatment indications and optimal management strategies of patients with intracranial unruptured aneurysms remain controversial.

Material-Method: In this study we present our results and clinical outcomes in a single center of patients with unruptured aneurysms treated with different endovascular techniques. Between April 2008 and October 2014, 106 unruptured aneurysms in 100 consecutive patients were treated with different endovascular techniques in our center. There were 35 male and 65 female patients with a median 53.2 years (range, 15-76 years). Endovascular primary coiling, coiling with balloon remodeling, stent assisted coiling, flow-diversion, intrasaccular flow-diversion or parent artery occlusion were performed according to location, type, complexity and size of the related unruptured aneurysms.

Results: At 6 months follow-up, complete occlusion was achieved in 101 aneurysms (100%) and near-complete occlusion in 5 aneurysms (90%-100%). Four patients had procedure-related complications including thromboembolism in 2 patients and aneurysm perforation during the procedure in 2 patients.  Follow-up imaging was performed with angiography in 61 patients, with CT angiography in 16 and with MR angiography in 23. Our median surveillance time was 10.05 months (6-50 months).

Conclusion: Endovascular treatment of unruptured intracranial aneurysms seems to be a safe method in selected patients according to risk-benefit analysis.

Keywords

• Unruptured intracranial aneurysms,Endovascular techniques,Embolization

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