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Titolo:
ENDOVASCULAR TREATMENT OF INTRACRANIAL AN EURYSMS
Autore:
PICARD L; BRACARD S; ANXIONNAT R; PRADA E; PER A; BURDIN D; HUMMER M; AUDIBERT G; MARCHAL JC; AUQUE J;
Indirizzi:
CHU,HOP URBAINS,SERV NEURORADIOL DIAGNOST & THERAPEUT F-54035 NANCY FRANCE
Titolo Testata:
Annales francaises d'anesthesie et de reanimation
fascicolo: 3, volume: 15, anno: 1996,
pagine: 348 - 353
SICI:
0750-7658(1996)15:3<348:ETOIAE>2.0.ZU;2-2
Fonte:
ISI
Lingua:
FRE
Soggetto:
SUBARACHNOID HEMORRHAGE; BALLOON EMBOLIZATION; SACCULAR ANEURYSMS; CEREBRAL ANEURYSMS; OCCLUSION; ELECTROTHROMBOSIS; VESSELS; COILS;
Keywords:
ENDOVASCULAR TREATMENT; ANEURYSMS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
21
Recensione:
Indirizzi per estratti:
Citazione:
L. Picard et al., "ENDOVASCULAR TREATMENT OF INTRACRANIAL AN EURYSMS", Annales francaises d'anesthesie et de reanimation, 15(3), 1996, pp. 348-353

Abstract

Major improvements have been achieved in endovascular treatment of intracranial aneurysms during the last twenty years. Initial techniques of selective balloon occlusion were progressively replaced by the packing of the aneurysmal pouch with very small and soft metallic devices,named coils, with controlled detachment. In some rare cases, balloon occlusion is still used in order to occlude the parent vessel or to reverse the flow, especially in the vertebro-basilar system. Essential aims for the anaesthesiologist include: complete immobility of the patient throughout the endovascular procedure, systemic anticoagulation inorder to avoid any thromboembolic complication during and after treatment, prevention and/or treatment of vasospasm, precise evaluation of fluid balance during the procedure. Our experience is based on 145 aneuryms in 135 patients, treated by endovascular route; 91 (63%) of themwere revealed by a subarachnoid haemorrhage (SAH). Their main locations were : the carotid siphon (33.1%), the anterior communicating artery (19.3%), the basilar artery (17.2%) and the middle cerebral artery (17.2%). Thirty-seven of these aneurysms (25.5%) were very small in size with a diameter less than 4 mm. Total or sub-total (more than 90%) occlusion was achieved in 141 aneurysms (90.3%). Thromboembolic complications occurred in eight patients (5.9%), neurological sequelae in one. Other treatment-related complications included the migration of a coil outside the aneurysm in six cases (4.4%) without neurological deficit in one and five ruptures of the aneurysm (3.7%) during the procedure with one lethal issue due to the spontaneous bleeding of a controlateral arterio-venous malformation. Thirteen patients died (9.6%). The cause of the death was related on the initial SAH in 11 of them. The two others were both due to rupture. of a second untreated aneurysm in one case and of an associated arteriovenous malformation in the second one. At present the main indications of endovascular treatment are poor or non indications for neurosurgery. Due to the quality of results, endovascular therapy will be more and more used in case of ruptured ornon ruptured aneurysms.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 17:26:31