[Endovascular treatment of middle cerebral artery bifurcation aneurysms].

Abstract

OBJECTIVE:

To summarize the diagnosis and endovascular treatment of middle cerebral artery (MCA) bifurcation aneurysm.

METHODS:

Between January 2010 and June 2011, 32 patients with MCA bifurcation aneurysm underwent endovascular treatment. There were 12 males and 20 females, aged 49.5 years on average (range, 35-81 years). All patients had sudden headache, 2 cases had disturbance of consciousness and hemiplegia, and 22 cases had a history of hypertension. Before operation, 10 cases were classified as Hunt-Hess level I, 15 cases as level II, and 7 cases as level III; 24 cases were classified as Fisher level II and 8 cases as level III. The patients underwent coil embolization using single microcatheter in 16 cases, using double microcatheter in 7 cases, using balloon-assisted in 4 cases, using single stent in 4 cases, and using double stent in 1 case.

RESULTS:

The results of postoperative immediate digital subtraction angiography showed that 30 patients achieved dense embolization, and 2 patients using single microcatheter achieved approximated dense embolization. Among them, 18 cases suffered extensive subarachnoid hemorrhage, thus lumbar puncture continued drainage was performed for 3-7 days; the other 14 cases had little subarachnoid hemorrhage, lumbar puncture released hemorrhagic cerebrospinal fluid discontinuously, and after 1 week, head CT demonstrated that subarachnoid hemorrhage was significantly decreased. At 1 day after surgery, 2 patients had local cerebral ischemia; after Nimotop and other drugs were used for 1 week, the symptom was alleviative. All 32 patients were followed up 4 to 17 months. No aneurysm rupture and bleed occurred during follow-up; no other complications or sequelae was observed except for 3 cases of hemiparesis and 1 case of aphasia. The computed tomographic angiography examination showed no re-open of dense embolized aneurysm at 3, 6 months, and 1 year after surgery.

CONCLUSION:

As long as appropriate intervention treatment method is chosen, endovascular treatment of MCA bifurcation aneurysm is safe and effective.

• Authors: Jun Yao, Wangdong Su, Ming Liu, Shilei Ni, Jie Gong, Lingyi Chi, Xiangyu Ma
• Journal: Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery (Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi) Vol. 26 Issue 7 Pg. 823-6 (Jul 2012) ISSN: 1002-1892 [Print] China
• PMID: 22905619 (Publication Type: English Abstract, Journal Article)

Topics

• Adult
• Aged
• Aged, 80 and over
• Aneurysm, Ruptured (pathology, therapy)
• Angiography, Digital Subtraction
• Blood Vessel Prosthesis
• Embolization, Therapeutic
• Female
• Follow-Up Studies
• Hemiplegia (etiology)
• Humans
• Intracranial Aneurysm (pathology, therapy)
• Male
• Middle Aged
• Middle Cerebral Artery
• Postoperative Complications
• Stents
• Subarachnoid Hemorrhage (etiology)
• Treatment Outcome