Comparison of Safety and Effect of Endovascular Treatments for Unruptured Intracranial Large or Giant Aneurysms in Internal Carotid Artery.

Comparison of Safety and Effect of Endovascular Treatments for Unruptured Intracranial Large or Giant Aneurysms in Internal Carotid Artery.

World Neurosurg. 2019 Jan 28;:

Authors: Yan P, Zhang Y, Liang F, Ma C, Liang S, Guo F, Jiang C

Abstract
PURPOSE: To analyze and compare the safety and efficacy of different endovascular treatment modalities for unruptured intracranial large or giant aneurysms.
METHODS: We retrospectively reviewed 126 consecutive patients with 128 large (15mm ≤size<25mm) or giant (≥ 25mm) aneurysms which were treated with different endovascular procedures between January 2014 and February 2017 in our center. We then compared clinical and angiographic outcomes, as well as the technical events rate among different treatment modalities.
RESULTS: In this study, complete occlusion at last follow-up was achieved in 65.6%, 90.5% and 72.0% of aneurysms in SAC, PAO and PED group (P=0.119). Both at 6 months (OR=1.81, P=0.396) and last angiographic follow-up (OR=3.64, P=0.123), PAO was not superior to PED regarding complete occlusion rate. Retreatment rate was statistically different among 3 groups (P<0.001) and the rate was highest in the SAC group (21.9%). The rates of hemorrhagic events and ischemic events were not significantly different among 3 groups (P=0.581). However, mass effect exacerbation was more frequently seen in SAC group (24.4% vs 7.7% and 3.3%, P=0.004). Major complication rate was higher in PAO group compared with PED group, however, the difference did not reach statistical difference (19.2% vs 16.4%, OR=1.21, P=0.763). The rate of technical events was statistically different in three groups (p=0.0437) and these problems occurred more often during the employment of PED (18.0%).
CONCLUSION: For large and giant aneurysms located in internal carotid artery, the outcome for endovascular treatment remains poor, even after the introduction of Pipeline embolization device.

PMID: 30703601 [PubMed - as supplied by publisher]

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