Flow diversion treatment for giant intracranial serpentine aneurysms
BackgroundGiant serpentine aneurysms (GSAs) are among the most complex and challenging type of intracranial aneurysms. Surgical clipping, bypass, or endovascular parent artery occlusion has been the main treatment of GSAs in the past. However, studies on flow diversion (FD) are limited. Therefore, w...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-11-01
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| Series: | Frontiers in Aging Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2022.988411/full |
| _version_ | 1811243780004642816 |
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| author | Xin Tong Zijun He Mingyang Han Xin Feng Xin Feng Chuanzhi Duan Chuanzhi Duan Aihua Liu |
| author_facet | Xin Tong Zijun He Mingyang Han Xin Feng Xin Feng Chuanzhi Duan Chuanzhi Duan Aihua Liu |
| author_sort | Xin Tong |
| collection | DOAJ |
| description | BackgroundGiant serpentine aneurysms (GSAs) are among the most complex and challenging type of intracranial aneurysms. Surgical clipping, bypass, or endovascular parent artery occlusion has been the main treatment of GSAs in the past. However, studies on flow diversion (FD) are limited. Therefore, we reported our experience with patients with GSAs treated with FD.MethodsPatients with GSAs treated with FD from 2012 to 2020 in our single center were retrospectively reviewed. Angiographic outcomes were graded according to the O’Kelly–Marotta scale as complete occlusion (D), trace filling (C), entry remnant (B), or aneurysm filling (A). Clinical outcomes were assessed using the modified Rankin scale (mRS) score. We also collected the patients’ treatment details and perioperative complications.ResultsThirteen patients with 14 aneurysms were included, including three in the anterior circulation and 11 in the posterior circulation. Grades B–D were found in 72.7% (8/11) of the GSAs. Good prognosis (mRS score, 0–2) was found in 66.7% (8/12) and 50.0% (6/12) of the patients at the 6-month and latest follow-up, respectively. Parent artery occlusion was found in three cases of GSAs. Five postoperative complications were observed, including two minor complications and three major complications.ConclusionAlthough reconstructive treatment with FD could be considered as one of the treatment strategies for patients with both anterior and posterior circulation GSAs, however, the risk of complications and parent artery occlusion should be considered. |
| first_indexed | 2024-04-12T14:13:26Z |
| format | Article |
| id | doaj.art-a30d499f1d304d7a85091af25b40d7ed |
| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-04-12T14:13:26Z |
| publishDate | 2022-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-a30d499f1d304d7a85091af25b40d7ed2022-12-22T03:29:48ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652022-11-011410.3389/fnagi.2022.988411988411Flow diversion treatment for giant intracranial serpentine aneurysmsXin Tong0Zijun He1Mingyang Han2Xin Feng3Xin Feng4Chuanzhi Duan5Chuanzhi Duan6Aihua Liu7Neurointerventional Center, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital University, Beijing, ChinaNeurointerventional Center, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital University, Beijing, ChinaDepartment of Neurosurgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan, ChinaNeurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital, Southern Medical University, Guangdong, ChinaGuangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Guangdong, ChinaNeurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital, Southern Medical University, Guangdong, ChinaGuangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Guangdong, ChinaNeurointerventional Center, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital University, Beijing, ChinaBackgroundGiant serpentine aneurysms (GSAs) are among the most complex and challenging type of intracranial aneurysms. Surgical clipping, bypass, or endovascular parent artery occlusion has been the main treatment of GSAs in the past. However, studies on flow diversion (FD) are limited. Therefore, we reported our experience with patients with GSAs treated with FD.MethodsPatients with GSAs treated with FD from 2012 to 2020 in our single center were retrospectively reviewed. Angiographic outcomes were graded according to the O’Kelly–Marotta scale as complete occlusion (D), trace filling (C), entry remnant (B), or aneurysm filling (A). Clinical outcomes were assessed using the modified Rankin scale (mRS) score. We also collected the patients’ treatment details and perioperative complications.ResultsThirteen patients with 14 aneurysms were included, including three in the anterior circulation and 11 in the posterior circulation. Grades B–D were found in 72.7% (8/11) of the GSAs. Good prognosis (mRS score, 0–2) was found in 66.7% (8/12) and 50.0% (6/12) of the patients at the 6-month and latest follow-up, respectively. Parent artery occlusion was found in three cases of GSAs. Five postoperative complications were observed, including two minor complications and three major complications.ConclusionAlthough reconstructive treatment with FD could be considered as one of the treatment strategies for patients with both anterior and posterior circulation GSAs, however, the risk of complications and parent artery occlusion should be considered.https://www.frontiersin.org/articles/10.3389/fnagi.2022.988411/fullgiant serpentine aneurysmflow diversionangiographic outcomeclinical outcomecomplication |
| spellingShingle | Xin Tong Zijun He Mingyang Han Xin Feng Xin Feng Chuanzhi Duan Chuanzhi Duan Aihua Liu Flow diversion treatment for giant intracranial serpentine aneurysms Frontiers in Aging Neuroscience giant serpentine aneurysm flow diversion angiographic outcome clinical outcome complication |
| title | Flow diversion treatment for giant intracranial serpentine aneurysms |
| title_full | Flow diversion treatment for giant intracranial serpentine aneurysms |
| title_fullStr | Flow diversion treatment for giant intracranial serpentine aneurysms |
| title_full_unstemmed | Flow diversion treatment for giant intracranial serpentine aneurysms |
| title_short | Flow diversion treatment for giant intracranial serpentine aneurysms |
| title_sort | flow diversion treatment for giant intracranial serpentine aneurysms |
| topic | giant serpentine aneurysm flow diversion angiographic outcome clinical outcome complication |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2022.988411/full |
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