Clinical and Angiographic Outcomes of Endovascular Treatment for Ruptured Posterior Circulation Cerebral Aneurysms.

AIM: To report the angiographic and clinical results achieved in endovascular treatment of ruptured posterior circulation cerebral aneurysms over a 3-year period. MATERIAL AND METHODS: A retrospective analysis of 45 patients was performed between June 2008 and June 2011. Clinical follow-up was achieved in all patients, with a mean duration of 17 months. Angiographic follow-up was obtained in 88.9% of cases, with a mean duration of 7.2 months. RESULTS: A clinical improvement, or stable outcome was achieved in all patients. There was one case of re-bleeding as a periprocedural complication 2 days after incomplete stent-assisted coiling of a vertebral artery aneurysm. There was no death in our patients. In 40 of the 45 patients (88.9%), angiographic follow-up was obtained at a mean of 7.2 months (range, 1 to 24 months). Recurrences in 5 patients (12.5%) at 2 days, 3, 6, 8, and 13 months required re-treatment. CONCLUSION: Endovascular embolization is an attractive option for ruptured posterior circulation aneurysms with stable long-term outcome. This study confirmed that endovascular treatment is associated with low mobidity and mortality. However, re-canalization may be observed up to 2 years after the initial obliteration. Long-term follow-up with angiography is needed.

Transarterial ONYX Embolization of Intracranial Dural Arteriovenous Fistulas in Adults.

AIM: To present our experience on transarterial treatment of dural arteriovenous fistulas (DAVFs) with ONYX in adult patients. MATERIAL AND METHODS: Between March 2008 and November 2012, 27 adult patients with DAVFs treated by transarterial ONYX embolization were included. Clinical data, including hospital records, operative reports, and angiograms, were reviewed and analyzed. RESULTS: Complete obliteration of the fistula was achieved in 16/27 (59.3%) patients after 32 intra-arterial embolizations. One complication (3.7%) was transient hemiparesis. Follow-up imaging, which was available for 16 fistulas with angiographic cures, showed no evidence of recurrence. At mean 14.5 months follow-up, 26 patients (96.3%) had GOS score of 5 and 1 patient (3.7%) had GOS score of 3. CONCLUSION: Transarterial ONYX embolization has become the main treatment for adult intracranial DAVFs and is associated with high safety and efficacy.

Indocyanine green videoangiography in clipping of paraclinoid aneurysms.

AIM: To evaluate the use of indocyanine green (ICG) videoangiography in surgical clipping of paraclinoid aneurysms. MATERIAL AND METHODS: Intraoperative ICG videoangiography was used as a surgical adjunct in 60 patients with 65 paraclinoid aneurysms. The findings on ICG videoangiography were compared with postoperative imaging. RESULTS: All 65 paraclinoid aneurysms were clearly identified by intraoperative ICG videoangiography and obliteration was documented in each case. Findings on ICG videoangiography matched with postoperative angiography. CONCLUSION: ICG videoangiography is a useful adjunct to the surgical management of paraclinoid aneurysms.