Endovascular coil embolization of proximal middle cerebral artery aneurysms has better outcomes than other middle cerebral artery aneurysms: A retrospective study

Document Type

Article

Abstract

PURPOSE: Although some authors proposed that coil embolization in middle cerebral artery (MCA) aneurysms is a useful and effective alternative, the characteristics of the aneurysms may be different at each location. We compared the results of coil embolization of proximal middle cerebral artery aneurysms with those of other middle cerebral artery aneurysms. METHODS: Data from 46 patients with 50 aneurysms were retrospectively evaluated. We defined the aneurysms inside of the insular cortex as proximal MCA (pMCA) aneurysms and those outside of the insular cortex as non-proximal MCA (npMCA) aneurysms. The results of the occlusion were divided into classes 1, 2, and 3 of the Raymond scale. We collected the results of the occlusion from the operative notes supplied by a neuroendovascular specialist. RESULTS: Univariate analysis identified favorable results for pMCA aneurysms (class 1: pMCA = 22 npMCA = 11; P < 0.01). In the radiological follow-up results, we achieved class 1 in 29 patients (69%; pMCA = 21 and npMCA = 8; P < 0.01). Side wall type aneurysms (pMCA = 14, npMCA = 2; P < 0.01) and the number of branches from the neck of ≤1 (pMCA = 14, npMCA = 2; P < 0.01) were significantly recognized at the pMCA. CONCLUSIONS: Proximal middle cerebral artery aneurysm clipping is difficult because the origin of the lenticulostriate arteries is often hidden behind the aneurysmal dome. In the present study, endovascular coil embolization for pMCA aneurysms obtained better results than that for npMCA aneurysms because of the morphological characteristics. Endovascular coil embolization seems to be efficacious for pMCA aneurysms as compared with npMCA aneurysms.

Keywords

Middle cerebral artery aneurysm, endovascular coil embolization, side wall type

Medical Subject Headings

Aged; Aneurysm, Ruptured (therapy); Embolization, Therapeutic (methods); Female; Humans; Intracranial Aneurysm (therapy); Male; Middle Aged; Middle Cerebral Artery; Retrospective Studies

Publication Date

6-1-2020

Publication Title

Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences

E-ISSN

2385-2011

Volume

26

Issue

3

First Page

268

Last Page

274

PubMed ID

31930940

Digital Object Identifier (DOI)

10.1177/1591019919896459

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