Efficacy of a direct puncture approach for anterior circulation aneurysms using a newly developed guiding catheter - especially for geriatric patients.

Abstract

BACKGROUND:

Endovascular surgery is being increasingly used as an alternative to craniotomy clipping surgery, especially for aged patients and complicated cases. However, tortuous atherosclerotic arteries sometimes interfere with advancement of catheters so that direct puncture may be necessary. Short guiding catheters for use with this approach have been newly developed, as discussed in this article.

METHODS:

One hundred twenty three anterior circulation aneurysms in 121 patients were consecutively treated by endovascular coil embolization, of which 42 (34%) were older than 70 years.

RESULTS:

With 21 aneurysms, coil embolization via the transfemoral approach failed, but all could be successfully treated with the direct puncture approach with minor complications such as 1 transient ischemic attack and 1 nonsymptomatic minor leakage. In the aged patients, the direct puncture approach with short guiding catheter resulted in complete obliteration of aneurysms in 20 (71%) of 28 with follow-up angiography.

CONCLUSION:

Direct puncture using newly developed short guiding catheters is an alternative to femoral approaches for patients with anterior circulation aneurysm with tortuous arteries and obvious atherosclerotic change at bifurcations of the common carotid artery.

• Authors: Izumi Yuzawa, Akira Kurata, Sachio Suzuki, Hitoshi Ozawa, Hiroyuki Hagiwara, Jun Niki, Masaru Yamada, Kiyotaka Fujii, Shinichi Kan, Takao Kitahara
• Journal: Surgical neurology (Surg Neurol) Vol. 67 Issue 1 Pg. 30-4; discussion 34 (Jan 2007) ISSN: 0090-3019 [Print] United States
• PMID: 17210291 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Aneurysm, Ruptured (therapy)
• Angioplasty (instrumentation)
• Carotid Artery, Common
• Embolization, Therapeutic (instrumentation)
• Equipment Design
• Female
• Humans
• Intracranial Aneurysm (therapy)
• Middle Aged
• Punctures (instrumentation)
• Retrospective Studies
• Treatment Outcome