Pericallosal aneurysm: a difficult challenge for microsurgery and endovascular treatment

Aboukais, Rabih; Zairi, Fahed; Bourgeois, Philippe; Boustia, Fakhreddine; Leclerc, Xavier; Lejeune, Jean-Paul

Document type :

Article dans une revue scientifique: Article original

DOI :

10.1016/j.neuchi.2015.03.010

PMID :

26072225

Permalink :

http://hdl.handle.net/20.500.12210/16009

Title :

Pericallosal aneurysm: a difficult challenge for microsurgery and endovascular treatment

Author(s) :

Aboukais, Rabih [Auteur]
Zairi, Fahed [Auteur]
Bourgeois, Philippe [Auteur]
Boustia, Fakhreddine [Auteur]
Leclerc, Xavier [Auteur]

Troubles cognitifs dégénératifs et vasculaires - U 1171 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 [TCDV]
Lejeune, Jean-Paul [Auteur]

Thérapies Laser Assistées par l'Image pour l'Oncologie - U 1189 [ONCO-THAI]

Journal title :

Neuro-Chirurgie

Abbreviated title :

Neurochirurgie

Volume number :

Pages :

244-249

Publication date :

2015-08-01

ISSN :

0028-3770

English keyword(s) :

Endovascular
Clipping
Aneurysm
Pericallosa

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Pericallosal artery aneurysms (PAA) represent 2 to 9% of intracranial aneurysms and their management remains difficult. OBJECTIVE: We aimed to report our experience to evaluate the outcome of patients with ...
Show more >BACKGROUND: Pericallosal artery aneurysms (PAA) represent 2 to 9% of intracranial aneurysms and their management remains difficult. OBJECTIVE: We aimed to report our experience to evaluate the outcome of patients with ruptured and unruptured PAA, when the treatment modality is decided in a multidisciplinary fashion. METHODS: In this retrospective study, we included 28 patients (8 men and 20 women) treated for a PAA in our institution between 2002 and 2012, among the 2430 patients who underwent the treatment of an intracranial aneurysm in the same period. Fifteen patients harbored a ruptured aneurysm while 13 benefited from a prophylactic treatment. The mean age at diagnosis was 52 years (range 37 to 75 SD: ± 5) in patients with ruptured aneurysm and 54.2 years (range 35 to 66 SD: ± 5) in patients with unruptured aneurysm. Endovascular treatment has been performed in 9 patients while 19 patients underwent a microsurgical treatment. Clinical outcome has been assessed using the modified Rankin scale (mRS) at 3 months. Long-term imaging follow-up included a CT angiography at 36 months for clipped aneurysms and MR angiography at 6, 18 and 36 months for coiled aneurysms. RESULTS: The median follow-up was 3.4 years (range 2.8 to 4.2). The mRS was ≤ 2 in all patients with unruptured aneurysms. In patients with ruptured aneurysm, the mRS was ≤ 2 at 3 months in 13 patients (87%). Persistent cognitive disorders were noted in 8 patients with ruptured aneurysm, 2 of them were considered as possibly related to the treatment. Aneurysm recurrence has been depicted in 4 patients (at 6 months in 3 patients and 1 year in 1 patient) requiring further treatment in all cases; all of them had an aneurysm remnant on immediate conventional angiography. No recurrence was noted in patients without remnant on immediate post-treatment angiography. CONCLUSIONS: Both endovascular and microsurgical treatment are challenged in this location. Multidisciplinary discussion is essential to optimize the management of patients with PAA.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
CNRS
INSERM
Inserm
Université de Lille

Collections :

Submission date :

2019-11-27T13:03:48Z

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