[Endovascular treatment of cerebral aneurysms: review of a ten year experience].

INTRODUCTION

We analyze the immediate and long-term clinical and angiographic results of endovascular treatment of ruptured and unruptured aneurysms in our single-center experience.

METHOD

Between January of 1996 and June of 2005, 145 aneurysms were treated endovascularly in 137 patients. The clinical follow-up was performed during hospitalization and then for at least one year (mean, 40 months) in the out-patient clinic. The results of the angiographic follow-up that was completed by 64.9% of the patients (mean: 33 months) were analyzed.

RESULTS

Initially, complete occlusion was obtained in 64.8% and partial (sac or neck remnant) in 22.1%. There were technique failures in 12 cases. Overall morbidity associated to the procedure was 8.1%. There was no case of direct mortality and only one case of post-embolization re-bleeding. Rate of complete final occlusion was 78.6 and recanalization 7.5%. Partial occlusion and recanalization rates correlated with aneurysm geometry (simple or complex), neck size and posterior localization. Age, clinical state at admission (Hunt-Hess grade III-V), time of treatment and the concomitant intraventricular hemorrhage correlated with worse clinical outcome (Rankin III-V) at day 90 (p<0.05).

DISCUSSION

In our experience, endovascular treatment is an effective and safe technique for cerebral aneurysms. Rate of morbidity and the only case of long recanalization demonstrate the procedure safety and stability of the middle-long term results. The large experience of our radiologists and the incorporation of new technical modalities have allowed us to improve the results, above all, in recent years.