CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S5
DOI: 10.1055/s-0041-1730658

Endovascular Management of Complex Wide-Neck Intracranial Aneurysms: Rashid Hospital Experience of the Current Day Armamentarium at Our Hands!

Yasir Jamil Khattak
Rashid Hospital, Dubai, UAE
Ayman Al Sibaie
Rashid Hospital, Dubai, UAE
› Author Affiliations

Background: Subarachnoid hemorrhage due to ruptured cerebral aneurysm is a disastrous event accounting for approximately 5%–15% of all stroke cases and has a mortality rate of 20%–40%. There has been a radical change in the management of intracranial aneurysms during the past decade. Endovascular approach is now considered as the management of first-choice over surgical means; however, it has its limitations with respect to wide-neck aneurysms. We present the results of our experiences of using assisted techniques for wide-neck aneurysms, with an emphasis on potential applications, technical aspects, and associated complications. Methods: A retrospective review was performed to identify all cases from 2010 to 2017 performed at our institution in which assisted techniques of aneurysm embolization were employed. Demographic data including age, gender, vascular risk factors, and comorbidities were collected. Angiographic data were collected regarding the location, size, and shape of the aneurysms and whether they were ruptured or unruptured. Angiographic occlusion results were evaluated and classified according to the Raymond-Roy Scale. Data regarding devices used were evaluated in relation to the aneurysm. Results: A total of 133 aneurysms in 119 subjects were embolized at our institution from 2010 till 2017 with 67 wide-neck aneurysms having a mean aspect ratio (maximum width of dome/width of neck) of 2.07. Eighty-one percent of patients presented with subarachnoid hemorrhage. Assisted techniques were employed in 63% of the cases. Eighty-seven percent of the wide-neck aneurysms were located in anterior circulation, while 13% belonged to posterior circulation. Complete occlusion (Raymond-Roy Occlusion Class 1) was achieved in 85% of cases. Conclusion: The data from Rashid hospital add to the growing evidence that assisted techniques are safe, effective, and necessary when embolizing wide-neck intracranial aneurysms. Further rigorous clinical evaluation of all techniques and devices is required to precisely assess their safety and efficacy in the management of wide-neck aneurysms.

Publication History

Article published online:
11 May 2021

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