Banner

The Relationship between Neck Size of the Cerebral Saccular Aneurysms and Outcome after Endovascular Intervention

Medical Journal of Cairo university • 2018
Back
Publication Information
Authors AHMED M. DEABES, M.Sc.; FATHY H. EL-NOSS, M.D.; HOSSAM I. MAATY, M.D.; AHMED A. ARAB, M.D. and MOHAMED N. SHADAD, M.D.
Keywords Key Words: Intracranial aneurysms – Endovascular intervention – Aspect ratio – Neck size.
Journal Medical Journal of Cairo university
Publisher Not Available
Volume 86
Issue 16
Pages 4689 - 4698
publication.type Local
Paper Link Open Link
Supplementary Materials Not Available
Abstract
Background: Intracranial aneurysms are common with a
prevalence of 0.2% to 9% in adults. Intracranial aneurysms
have high mortality and morbidity, so exclusion of aneurysms
from cerebral circulation is aimed with established endovascular embolization.
Aim of Study: Is to report our experience in managing
intracranial aneurysms using coil embolization and to report
the relation between neck size of cerebral aneurysms, its
relation to dome height which is defined as Aspect Ratio
(AR), and clinical, angiographic outcome after endovascular
intervention.
Patients and Methods: From July 2015 to May 2017, a
series of 40 nonrandomized consecutive patients (mean age:
44.2± 14.9 years) with 42 intracranial aneurysms underwent
endovascular coil embolization in our center. We excluded
patients with H & H grade 5 on admission and patients with
H & H grade 4 were managed conservatively until improvement with better H&H grade. All patients were evaluated by
four-vessel angiography to determine the shape, size, number
and location of the aneurysms. Degree of aneurysm occlusion
were assessed according to modified Raymond Roy classification. The cases were divided according to neck size, 4mm
being the discriminative value for small and wide necks and
divided according to aspect ratio into AR >2, AR 1.5-2, AR
1-1.5, AR 1.5 with modified Raymond classification are; class I was
achieved in 22 (68.8%) aneurysms, class II in 8 (25%) aneurysms, class IIIa in one (3.1%) aneurysm, class IIIb in one
(3.1%) aneurysm. The wide necked group and AR 1.5, but in aneurysms with
wide neck and AR