Journal of Yeungnam Medical Science

Original articles

Feasibility and efficacy of coil embolization for middle cerebral artery aneurysms: Jae Young Choi, Chang Hwa Choi, Jun Kyeung Ko, Jae Il Lee, Chae Wook Huh, Tae Hong Lee; Yeungnam Univ J Med. 2019;36(3):208-218. Published online April 25, 2019; DOI: https://doi.org/10.12701/yujm.2019.00192

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Background
The anatomy of middle cerebral artery (MCA) aneurysms has been noted to be unfavorable for endovascular treatment. The purpose of this study was to assess the feasibility and efficacy of coiling for MCA aneurysms.
Methods
From January 2004 to December 2015, 72 MCA aneurysms (38 unruptured and 34 ruptured) in 67 patients were treated with coils. Treatment-related complications, clinical outcomes, and immediate and follow-up angiographic outcomes were retrospectively analyzed.
Results
Aneurysms were located at the MCA bifurcation (n=60), 1st segment (M1, n=8), and 2nd segment (M2, n=4). Sixty-nine aneurysms (95.8%) were treated by neck remodeling techniques using multi-catheter (n=44), balloon (n=14), stent (n=8), or combination of these (n=3). Only three aneurysms were treated by single-catheter technique. Angiographic results were 66 (91.7%) complete, five (6.9%) remnant neck, and one (1.4%) incomplete occlusion. Procedural complications included aneurysm rupture (n=1), asymptomatic coil migration to the distal vessel (n=1), and acute thromboembolism (n=10) consisting of eight asymptomatic and two symptomatic events. Treatment-related permanent morbidity and mortality rates were 4.5% and 3.0%, respectively. There was no bleeding on clinical follow-up (mean, 29 months; range, 6-108 months). Follow-up angiographic results (mean, 26 months; range, 6-96 months) in patients included one major and three minor recanalizations.
Conclusion
Coiling of MCA aneurysms could be a technically feasible and clinically effective treatment strategy with acceptable angiographic and clinical outcomes. However, the safety and efficacy of this technique as compared to surgical clipping remains to be ascertained.

Citations

Citations to this article as recorded by

Adverse events during endovascular treatment of ruptured aneurysms: A prospective nationwide study on subarachnoid hemorrhage in Sweden
Bryndís Baldvinsdóttir, Paula Klurfan, Johanna Eneling, Elisabeth Ronne-Engström, Per Enblad, Peter Lindvall, Helena Aineskog, Steen Friðriksson, Mikael Svensson, Peter Alpkvist, Jan Hillman, Erik Kronvall, Ola G. Nilsson
Brain and Spine.2023; 3: 102708. CrossRef
Microsurgical Clipping versus Advanced Endovascular Treatment of Unruptured Middle Cerebral Artery Bifurcation Aneurysms After a “Coil-First” Policy
Muriel Pflaeging, Christoph Kabbasch, Marc Schlamann, Lenhard Pennig, Stephanie Theresa Juenger, Jan-Peter Grunz, Marco Timmer, Gerrit Brinker, Roland Goldbrunner, Boris Krischek, Lukas Goertz
World Neurosurgery.2021; 149: e336. CrossRef

Comparison of three different endoscopic approaches in the treatment of bladder calculi: Jae Youn Jang, Young Hwii Ko, Phil Hyun Song, Jae Young Choi; Yeungnam Univ J Med. 2019;36(1):16-19. Published online December 19, 2018; DOI: https://doi.org/10.12701/yujm.2019.00045

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Abstract PDF

Background
This study compared the following three endoscopic techniques used to treat bladder stones: transurethral cystoscope used with a pneumatic lithoclast or nephroscope used with a pneumatic lithoclast and nephroscope used with an ultrasonic lithoclast.
Methods
Between January 2013 and May 2016, 107 patients with bladder stones underwent endoscopic treatment. Patients were classified into 3 groups based on the endoscopic techniques and energy modalities used in each group as: group 1 (transurethral stone removal using a cystoscope with pneumatic lithoclast), group 2 (transurethral stone removal using a nephroscope with pneumatic lithoclast), and group 3 (transurethral stone removal using a nephroscope with ultrasonic lithoclast). Baseline and perioperative data were retrospectively compared between three groups.
Results
No statistically significant intergroup differences were observed in age, sex ratio, and stone size. A statistically significant intergroup difference was observed in the operation time—group 1: 71.3±46.6 min; group 2: 33.0±13.7 min; and group 3: 24.6±8.0 min. All patients showed complete stone clearance. The number of urethral entries was higher in group 1 than in the other groups. Significant complications did not occur in any patient.
Conclusion
Nephroscopy scores over cystoscopy for the removal of bladder stones with respect to operation time. Ultrasonic lithoclast is a safe and efficacious modality that scores over a pneumatic lithoclast with respect to the operation time.

Citations

Citations to this article as recorded by

Comparison of nephroscopy and cystoscopy used in the treatment of bladder stones: a systematic review and meta-analysis of randomized controlled trials
Liping Gou, Zhenghao Wang, Ye Zhou, Xiaofeng Zheng
BMC Surgery.2021;[Epub] CrossRef

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