Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection

Michel E. Mawad, Saruhan Cekirge, Elisa Ciceri, Isil Saatci

Research output: Contribution to journalArticle

Abstract

Object. The aim of this study was to test the feasibility, safety, and efficacy of a new endovascular method for the treatment of giant intracranial aneurysms. This new method consists of combining a metallic stent with a liquid polymer; the stent is first placed across the neck of the aneurysm to reconstruct a tubular arterial lumen, followed by obliteration of the fundus of the aneurysm with an ethyl vinyl alcohol polymer. During its injection, the liquid polymer is contained within the aneurysm by temporarily inflating an occlusion balloon in the parent artery. Methods. Eleven patients harboring a giant aneurysm were successfully treated using this procedure. All aneurysms were excluded from the circulation, with preservation of the parent artery. In nine of the 11 patients, the 6-month follow-up angiogram demonstrated no recanalization of the aneurysm. In one patient who had a giant and partially clotted internal carotid artery bifurcation aneurysm, the follow-up angiogram demonstrated minimal recanalization. The complications in this series of patients included one death and one case of transient hemiparesis caused by watershed ischemia. Conclusions. The initial anatomical results and the clinical outcome in this small series of patients are very encouraging. The mortality and morbidity rates associated with this new endovascular treatment are superior to those associated with surgical clipping of giant aneurysms.

Original languageEnglish
Pages (from-to)474-482
Number of pages9
JournalJournal of Neurosurgery
Volume96
Issue number3
Publication statusPublished - 2002

Fingerprint

Intracranial Aneurysm
Stents
Aneurysm
Polymers
Injections
Therapeutics
Angiography
Arteries
Balloon Occlusion
Internal Carotid Artery
Paresis
Ethanol
Ischemia
Morbidity
Safety
Mortality

Keywords

  • Endovascular occlusion
  • Fusiform aneurysm
  • Giant aneurysm
  • Stent
  • Unruptured intracranial aneurysm

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

Cite this

Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection. / Mawad, Michel E.; Cekirge, Saruhan; Ciceri, Elisa; Saatci, Isil.

In: Journal of Neurosurgery, Vol. 96, No. 3, 2002, p. 474-482.

Research output: Contribution to journalArticle

Mawad, Michel E. ; Cekirge, Saruhan ; Ciceri, Elisa ; Saatci, Isil. / Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection. In: Journal of Neurosurgery. 2002 ; Vol. 96, No. 3. pp. 474-482.
@article{ae2b9ed5f7264e589a50a0305c5a930a,
title = "Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection",
abstract = "Object. The aim of this study was to test the feasibility, safety, and efficacy of a new endovascular method for the treatment of giant intracranial aneurysms. This new method consists of combining a metallic stent with a liquid polymer; the stent is first placed across the neck of the aneurysm to reconstruct a tubular arterial lumen, followed by obliteration of the fundus of the aneurysm with an ethyl vinyl alcohol polymer. During its injection, the liquid polymer is contained within the aneurysm by temporarily inflating an occlusion balloon in the parent artery. Methods. Eleven patients harboring a giant aneurysm were successfully treated using this procedure. All aneurysms were excluded from the circulation, with preservation of the parent artery. In nine of the 11 patients, the 6-month follow-up angiogram demonstrated no recanalization of the aneurysm. In one patient who had a giant and partially clotted internal carotid artery bifurcation aneurysm, the follow-up angiogram demonstrated minimal recanalization. The complications in this series of patients included one death and one case of transient hemiparesis caused by watershed ischemia. Conclusions. The initial anatomical results and the clinical outcome in this small series of patients are very encouraging. The mortality and morbidity rates associated with this new endovascular treatment are superior to those associated with surgical clipping of giant aneurysms.",
keywords = "Endovascular occlusion, Fusiform aneurysm, Giant aneurysm, Stent, Unruptured intracranial aneurysm",
author = "Mawad, {Michel E.} and Saruhan Cekirge and Elisa Ciceri and Isil Saatci",
year = "2002",
language = "English",
volume = "96",
pages = "474--482",
journal = "Journal of Neurosurgery",
issn = "0022-3085",
publisher = "American Association of Neurological Surgeons",
number = "3",

}

TY - JOUR

T1 - Endovascular treatment of giant and large intracranial aneurysms by using a combination of stent placement and liquid polymer injection

AU - Mawad, Michel E.

AU - Cekirge, Saruhan

AU - Ciceri, Elisa

AU - Saatci, Isil

PY - 2002

Y1 - 2002

N2 - Object. The aim of this study was to test the feasibility, safety, and efficacy of a new endovascular method for the treatment of giant intracranial aneurysms. This new method consists of combining a metallic stent with a liquid polymer; the stent is first placed across the neck of the aneurysm to reconstruct a tubular arterial lumen, followed by obliteration of the fundus of the aneurysm with an ethyl vinyl alcohol polymer. During its injection, the liquid polymer is contained within the aneurysm by temporarily inflating an occlusion balloon in the parent artery. Methods. Eleven patients harboring a giant aneurysm were successfully treated using this procedure. All aneurysms were excluded from the circulation, with preservation of the parent artery. In nine of the 11 patients, the 6-month follow-up angiogram demonstrated no recanalization of the aneurysm. In one patient who had a giant and partially clotted internal carotid artery bifurcation aneurysm, the follow-up angiogram demonstrated minimal recanalization. The complications in this series of patients included one death and one case of transient hemiparesis caused by watershed ischemia. Conclusions. The initial anatomical results and the clinical outcome in this small series of patients are very encouraging. The mortality and morbidity rates associated with this new endovascular treatment are superior to those associated with surgical clipping of giant aneurysms.

AB - Object. The aim of this study was to test the feasibility, safety, and efficacy of a new endovascular method for the treatment of giant intracranial aneurysms. This new method consists of combining a metallic stent with a liquid polymer; the stent is first placed across the neck of the aneurysm to reconstruct a tubular arterial lumen, followed by obliteration of the fundus of the aneurysm with an ethyl vinyl alcohol polymer. During its injection, the liquid polymer is contained within the aneurysm by temporarily inflating an occlusion balloon in the parent artery. Methods. Eleven patients harboring a giant aneurysm were successfully treated using this procedure. All aneurysms were excluded from the circulation, with preservation of the parent artery. In nine of the 11 patients, the 6-month follow-up angiogram demonstrated no recanalization of the aneurysm. In one patient who had a giant and partially clotted internal carotid artery bifurcation aneurysm, the follow-up angiogram demonstrated minimal recanalization. The complications in this series of patients included one death and one case of transient hemiparesis caused by watershed ischemia. Conclusions. The initial anatomical results and the clinical outcome in this small series of patients are very encouraging. The mortality and morbidity rates associated with this new endovascular treatment are superior to those associated with surgical clipping of giant aneurysms.

KW - Endovascular occlusion

KW - Fusiform aneurysm

KW - Giant aneurysm

KW - Stent

KW - Unruptured intracranial aneurysm

UR - http://www.scopus.com/inward/record.url?scp=0036125841&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036125841&partnerID=8YFLogxK

M3 - Article

C2 - 11883831

AN - SCOPUS:0036125841

VL - 96

SP - 474

EP - 482

JO - Journal of Neurosurgery

JF - Journal of Neurosurgery

SN - 0022-3085

IS - 3

ER -