Journal of Yeungnam Medical Science

Original article

Feasibility and efficacy of coil embolization for middle cerebral artery aneurysms: Jae Young Choi, Chang Hwa Choi, Jun Kyeung Ko, Jae Il Lee, Chae Wook Huh, Tae Hong Lee; Yeungnam Univ J Med. 2019;36(3):208-218. Published online April 25, 2019; DOI: https://doi.org/10.12701/yujm.2019.00192

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Background
The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms.
Methods
From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed.
Results
Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only three aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, five (6.9%) remnant neck, and one (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of eight asymptomatic and two symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included one major and three minor recanalizations.
Conclusion
Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.

Citations

Citations to this article as recorded by

Adverse events during endovascular treatment of ruptured aneurysms: A prospective nationwide study on subarachnoid hemorrhage in Sweden
Bryndís Baldvinsdóttir, Paula Klurfan, Johanna Eneling, Elisabeth Ronne-Engström, Per Enblad, Peter Lindvall, Helena Aineskog, Steen Friðriksson, Mikael Svensson, Peter Alpkvist, Jan Hillman, Erik Kronvall, Ola G. Nilsson
Brain and Spine.2023; 3: 102708. CrossRef
Microsurgical Clipping versus Advanced Endovascular Treatment of Unruptured Middle Cerebral Artery Bifurcation Aneurysms After a “Coil-First” Policy
Muriel Pflaeging, Christoph Kabbasch, Marc Schlamann, Lenhard Pennig, Stephanie Theresa Juenger, Jan-Peter Grunz, Marco Timmer, Gerrit Brinker, Roland Goldbrunner, Boris Krischek, Lukas Goertz
World Neurosurgery.2021; 149: e336. CrossRef

Case Report

Fibromuscular Dysplasia of the Distal Internal Carotid and Middle Cerebral Artery.: Ju Hyun Kim, Jun Lee; Yeungnam Univ J Med. 2009;26(1):78-83. Published online June 30, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.1.78

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Abstract PDF

Fibromuscular dysplasia is an uncommon condition of idiopathic, non-inflammatory and non-atherosclerotic disease of the musculature of arterial walls. The disease is rare, but it commonly affects young and middle aged women. Isolated intracranial cerebral fibromuscular dysplasia is extremely rare because cerebral fibromuscular dysplasia usually affects extracranial vessels. A 26-year-old woman was admitted with right hemiplegia and global aphasia. Brain MRI and MRA demonstrated acute left middle cerebral artery territory infarction with a multifocal stenosis and dilatation of the left middle cerebra artery and left internal carotid. The characteristic conventional cerebral angiographic findings demonstrated a typical string-of-beads appearance in the left distal internal carotid artery and proximal portion of the left middle cerebral artery, which suggested a medial type fibromuscular dysplasia. We report a case of isolated intracranial fibromuscular dysplasia with left middle cerebral artery territory infarction. Fibromuscular dysplasia should be considered as a stroke risk factors in children and young adults, especially in patients with no known cardiovascular risk factors.

Citations

Citations to this article as recorded by

Cerebral Infarction and Recovery in a 12-Year-Old Child With Intracranial Fibromuscular Dysplasia
Min Hwan Kim, Jae In Lee, Shin-seung Yang
Brain & Neurorehabilitation.2023;[Epub] CrossRef

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