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Neuroradiology

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01-11-2012 | Interventional Neuroradiology

Endovascular treatment of proximal superior middle cerebral artery aneurysms

Authors: Boris Lubicz, Martina Pezzullo, Denis Brisbois, Olivier De Witte, Benjamin Mine

Published in: Neuroradiology | Issue 11/2012

Abstract

Introduction

Aneurysms superiorly located on the proximal segment of the middle cerebral artery (PMCAA) are rare and challenging to treat. No information is available regarding their management by endovascular approach. The aim of this study was to report our experience with endovascular treatment (EVT) of PMCAA.

Methods

A retrospective review of our prospectively maintained database identified all PMCAA treated in our institution. The clinical charts, procedural data, and angiographic results were reviewed.

Results

From April 2004 to December 2011, 17 patients were identified including six who presented with subarachnoid hemorrhage (SAH) and 11 with an unruptured PMCAA. All aneurysms were small (<6 mm) and had a branch arising from the neck or the sac, and 15/17 were wide-necked. All patients were successfully treated by balloon-assisted coiling (n = 10), stent-assisted coiling (n = 5), and coiling (n = 2). No technical or clinical complication occurred. Fifteen patients showed an excellent clinical outcome, and two kept a slight or a significant deficit that were both SAH-related. Immediate anatomical outcome includes nine complete occlusions and eight neck remnants. Imaging follow-up in 11 patients (mean = 21, range, 6 to 60 months) showed stable or improved results in all cases.

Conclusion

Our study is the first reported series of patients with PMCAA treated by selective embolization. It suggests that EVT is a safe and effective alternative to surgery for the management of PMCAA. Balloon- or stent-assisted coiling are needed in most cases because of PMCAA morphological characteristics.

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Title: Endovascular treatment of proximal superior middle cerebral artery aneurysms
Authors: Boris Lubicz
Martina Pezzullo
Denis Brisbois
Olivier De Witte
Benjamin Mine
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 11/2012
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-012-1043-7

At a glance: The STEP trials

Springer Medicine

Endovascular treatment of proximal superior middle cerebral artery aneurysms

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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