1. Stent-assisted coiling of acute ruptured cerebral aneurysms
- Author
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Vadim V. Berestov, Kirill Yu. Orlov, Alexei L. Krivoshapkin, Nikolay V. Strelnikov, Anastasia I. Somova, Dmitriy S. Kislitsin, Anton V. Gorbatykh, Pavel O. Seleznev, Timur S. Shayakhmetov, and Lev M. Kirillov
- Subjects
medicine.medical_specialty ,Vascular anatomy ,business.industry ,medicine.medical_treatment ,Significant difference ,Stent ,Treatment method ,acute rupture ,medicine.disease ,Surgery ,Aneurysm ,Occlusion ,medicine ,stent assistance ,Medicine ,Embolization ,cardiovascular diseases ,Endovascular treatment ,business ,cerebral aneurysms - Abstract
The necessity of quick surgical treatment of acute ruptured cerebral aneurysms was demonstrated in large studies by the ISAT and ISUIA, which also proved the advantage of the endovascular method over the surgical one. Ballonassistence is widely used in treatment of aneurysms with wide neck and unfavorable vascular anatomy, but the radicality of the treatment is insufficient. The aim of this study was to demonstrate the efficacy and safety of stent-assisted embolization of «acute» cerebral aneurysms. Material and methods. A retrospective analysis of the treatment of 234 patients with «acute» cerebral aneurysms was carried out. Results. Only coils were used in 40.6 % of cases (n = 95), balloon-assistance, in 40.2 % of cases (n = 94), and stent-assistance, in 19.2 % of cases (n = 45). There were 11.5 % (n = 27) clinically significant complications. Total aneurysm occlusion (Raymond-Roy I) was achieved in 187 cases (79.9 %); the radicality at the control examination was 67.1 % (157 patients). Discussion. The radicality of the treatment with stents was slightly higher then with balloons and coils at the end of operation (84.4 %, n = 38 and 78.8 %, n = 149, p > 0.05), but it was significantly higher at the control examination (80.0 %, n = 36 and 60.8 %, n = 115, respectively, p Conclusions. Intracranial stents allow achieving good results of the embolization of complex aneurysms in the acute period of intracranial hemorrhage without increasing the risk of surgical treatment.
- Published
- 2021