Endovascular treatment of pericallosal aneurysms

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  • 1 Department of Radiology, Centre Hospitalier de l'Université de Montréal, Notre-Dame Hospital; and
  • | 2 Department of Mathematics and Statistics, Université de Montréal, Quebec, Canada
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Object

Pericallosal artery aneurysms are uncommon. Their treatment strategy, surgical or endovascular, will present specific challenges. The objective of the study was to compare risks of coil therapy and the recurrence rate of pericallosal artery aneurysms with aneurysms in other intradural locations.

Methods

The authors examined data that were stored in a prospectively collected database for pericallosal artery aneurysms in patients who underwent coil placement between 1992 and 2005. Hemorrhagic and thromboembolic complications as well as clinical and angiographic outcomes were reviewed. Angiographically documented recurrences were classified as minor or major. These lesions were compared with a historical cohort of non–pericallosal artery aneurysms in patients who underwent coil therapy between 1992 and 2002. The known risk factors for recurrence and procedure-related hemorrhagic complications were evaluated in both groups to assess baseline imbalances.

Results

During a 13-year period, 25 pericallosal artery aneurysms were treated with coils in 25 patients. The non–pericallosal artery lesion group included 488 aneurysms of which 344 underwent follow-up imaging. Procedure-related perforations were more frequent for pericallosal artery aneurysms than those in other intradural locations (three of 25 compared with eight of 476, respectively; risk ratio 7.1, 95% confidence interval [CI] 2.1–22.5, p = 0.03). Follow-up imaging studies (obtained at a mean 28 months) were available for 19 patients with pericallosal artery aneurysms. The recurrence rate was not significantly higher in these patients (22.9/100 person–years of observation) than in those with non–pericallosal artery aneurysms (17.9/100 person–years of observation) (incidence rate ratio 1.3, 95% CI 0.6–2.4, p = 0.46).

Conclusions

Pericallosal artery aneurysms were associated with significantly higher periprocedural rupture than non–pericallosal artery lesions. No significant intergroup difference was found for aneurysm recurrence.

Abbreviations used in this paper:

CI = confidence interval; mRS = modified Rankin Scale.

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  • 1

    Byrne JV, , Sohn MJ, , Molyneux AJ, & Chir B: Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. J Neurosurg 91:656663, 1999

    • Search Google Scholar
    • Export Citation
  • 2

    Cloft HJ, & Kallmes DF: Cerebral aneurysm perforations complicating therapy with Guglielmi detachable coils: a meta-analysis. AJNR Am J Neuroradiol 23:17061709, 2002

    • Search Google Scholar
    • Export Citation
  • 3

    de Sousa AA, , Dantas FL, , de Cardoso GT, & Costa BS: Distal anterior cerebral artery aneurysms. Surg Neurol 52:128135, 1999

  • 4

    Kawashima M, , Matsushima T, & Sasaki T: Surgical strategy for distal anterior cerebral artery aneurysms: microsurgical anatomy. J Neurosurg 99:517525, 2003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5

    Keseton P, , White P, , Horribine L, & Sellar R: The endovascular management of pericallosal artery aneurysms. J Neuroradiol 31:384390, 2004

  • 6

    Mann KS, , Yue CP, & Wong G: Aneurysms of the pericallosalcal-losomarginal junction. Surg Neurol 21:261266, 1984

  • 7

    Menovsky T, , van Rooij WJ, , Sluzewski M, & Wijnalda D: Coiling of ruptured pericallosal artery aneurysms. Neurosurgery 50:1115, 2002

  • 8

    Molyneux AJ, , Kerr RS, , Stratton I, , Sandercock P, , Clarke M, & Shrimpton J, et al.: International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International subarachnoid aneurysm trial of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:12671274, 2002

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9

    Molyneux AJ, , Kerr RS, , Yu LM, , Clarke M, , Sneade M, & Yarnold JA, et al.: International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International subarachnoid aneurysm trial of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809817, 2005

    • Search Google Scholar
    • Export Citation
  • 10

    Pierot L, , Boulin A, , Castaings L, , Rey A, & Moret J: Endovascular treatment of pericallosal artery aneurysms. Neurol Res 18:4953, 1996

  • 11

    Raymond J, , Guilbert F, , Weill A, , Georganos SA, , Juravsky L, & Lambert A, et al.: Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke 34:13981403, 2003

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12

    Sluzewski M, , Bosch JA, , van Rooij WJ, , Nijssen PC, & Wijnalda D: Rupture of intracranial aneurysms during treatment with Guglielmi detachable coils: incidence, outcome, and risk factors. J Neurosurg 94:238240, 2001

    • Crossref
    • Search Google Scholar
    • Export Citation

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