Endovascular Parent Artery Occlusion for Intracranial Aneurysms is a Viable, Cost-Effective Alternative: An Institutional Experience from Northeast India
Research papers
Pranjal Phukan
North Eastern Indira Gandhi Regional Institute of Health & Medical Science
Kalyan Sarma
All India Institute of Medical Science, New Delhi
Donboklang Lynser
North Eastern Indira Gandhi Regional Institute of Health & Medical Science
Barun Kumar Sharma
Sikkim Manipal Institute of Medical Sciences, India
Deb Kumar Baruah
Tezpur Medical College, India
Bishwajit Saikia
North Eastern Indira Gandhi Regional Institute of Health & Medical Science
Binoy Kumar Singh
North Eastern Indira Gandhi Regional Institute of Health & Medical Science
Published 2021-08-04
https://doi.org/10.15388/Amed.2021.28.2.6
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Keywords

Intracranial Aneurysm
Balloon Occlusion
Endovascular

How to Cite

1.
Phukan P, Sarma K, Lynser D, et al. Endovascular Parent Artery Occlusion for Intracranial Aneurysms is a Viable, Cost-Effective Alternative: An Institutional Experience from Northeast India. AML. 2021;28(2):272-284. doi:10.15388/Amed.2021.28.2.6

Abstract

Purpose. Endovascular parent artery occlusion (PAO) may be an alternative approach for complex intracranial aneurysm with potentially life-threatening complications. Moreover, the long-term follow-up of the PAO for an intracranial aneurysm is reported sparingly, limited to the case series. It is therefore important to carry out more research on long-term follow-up of the implication of PAO of intracranial aneurysm. The aim of the study was to analyses our experience of PAO for intracranial aneurysms with emphasis on long-term follow-up.
Materials and Methods. The data of patients treated with PAO for intracranial aneurysms were reviewed. The outcome was evaluated based on aneurysmal occlusion on immediate angiography, follow-up magnetic resonance angiography (MRA), and complications. The modified Rankin score (mRS) was used to evaluate the functional outcome during the last follow-up. The mean, range, and standard deviation were reported for other variables – the patient’s age, number, and percentage.
Results. Endovascular treatment was performed in 178 patients including PAO in 18 patients. Of these 18 (eighteen) patients, there were 13 dissecting aneurysms, 4 mycotic aneurysms, and one traumatic aneurysm.
10 (ten) patients underwent PAO for proximal intracranial artery aneurysm and 8 (eight) patients for distal cerebral aneurysms. Complete occlusion of the aneurysm was achieved in 16patients (88.89%) and retrograde filling of the aneurysm was seen in 2 (11.11%) patients. One patient had intraprocedural coil migration resulting in a major infarct with an mRS of 2. Another patient (5.56%) had recanalization of the aneurysm and presented with rupture and intracranial hemorrhage with an mRS score of 4. The mRS of the other 16 patients (88.89%) was zero.
Conclusions. Endovascular PAO for cerebral aneurysms was highly feasible and achieved complete occlusion. The morbidity and mortality rates were at the long-term follow-up also acceptable with negligible complications.

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