Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Maderbacher, G.
10-Jahres Ergebnis endovaskulär behandelter intrakranieller Aneurysmen.
[ Diplomarbeit/Master Thesis ] Graz Medical University; 2009. pp. 149
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Leber Klaus
- Niederkorn Kurt
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- Abstract:
- Introduction: As there have mainly been published mid-term results of endovascularly treated intracranial aneurysms so far, the intention of this study was to assess the 10-year results of mortality, morbidity, radiological stability and complications of endovascular treatment. Material & Methods: 91 patients, 39 patients with non ruptured and 52 patients with ruptured aneurysms (18 were classified as Hunt & Hess (H&H) 1, 10 H&H 2, 17 H&H 3, 6 H&H 4 und 1 H&H 5) with 119 aneurysms who were treated between 1992 and 1998 only endovascularly were analyzed. Radiological results were assessed in the 70 surviving patients with 92 aneurysms who were followed in average for 10.4 years. Results: In total 5.5% (5/91) died related to treatment 7.7% (4/52) of patients with ruptured and 2.7% (1/39) with non ruptured aneurysms. Complete aneurysm occlusion after the first endovascular treatment was observed in 66.3% (61/92) of aneurysms. Of 33.7% (31/92) of aneurysms, that were initially not completely occluded, 67.7% (21/31) were in average 2.2 times retreated. In average of 4.2 years after the first treatment 47.8% (44/92) of the aneurysms showed recurrence. Of these, 59.1% (26/44) were in average 1.6 times retreated. Aneurysms that showed recurrence were significantly larger in size than the ones that did not (p<0.02). In 61.5% (16/26) of the successfully treated recurrent aneurysms, there was found another recurrence. At the point of the last radiological examination, 63.0% (58/92) of the aneurysms were completely occluded. Both aneurismal rupture and clinical relevant thrombosis or embolism were observed in 3.3% (3/91), both vascular dissection and symptomatic vasospasm in 1.1% (1/91). Discussion: Due to the observed recurrence rate and the corresponding literature, stability of endovascular treated aneurysms is not comparable to surgically clipped aneurysms. As we found recurrent aneurysms ten years and later, consequent and longterm follow up seems necessary and makes sense.