Prague Med. Rep. 2024, 125, 15-33

Outcome after Neuro-interventional Treatment of Intracranial Aneurysm (as a First Treatment Modality)

Hossein Ghanaati1, Aryoobarzan Rahmatian2,3, Mohammad Reza Amiri-Nikpour3, Davar Altafi3, Morteza Taheri3,4, Seyed Bahaadin Siroos3, Madjid Shakiba1, Reza Elahi1, Mahsa Alborzi Avanaki1

1Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Emam-Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
2Department of Neurology, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
3Iranian Center of Neurological Research, Department of Neurovascular Intervention, Tehran University of Medical Sciences, Tehran, Iran
4Iran University of Medical Sciences, Tehran, Iran

Received September 8, 2022
Accepted February 1, 2024

Endovascular treatment is widely applied as the first-line treatment for intracranial aneurysms and includes simple coiling (SC), stent-assisted coiling (SAC), flow diversion stent, and flow disruption stent. The present study is a retrospective cohort study performed in Imam Khomeini Hospital, Department of Neurovascular Intervention, between March 2016 and March 2021. A total number of 229 patients with intracranial aneurysms who underwent therapeutic intravascular interventions were enrolled, of which 89 were treated with SC, 111 with SAC, 25 with flow diversion stent, and 4 with flow disruption stent. The mean age of the subjects was 51.8±12.6 years, and 51.1% were male. Modified Raymond-Roy classification (MRRC) was used to define the occlusion outcome. The success rate, considered as Class I and Class II of MRRC at treatment time was 89% (94.4% in SC, and 84.7% in SAC), which was increased to 90.9% (94% in SC, 93% in SAC, 69.6% in flow diversion stenting, 100% in flow disruption) at 6-month follow-up, and 84.6% (80.8% in SC, 87.8% in SAC, 78.3% in flow diversion stenting, and 100% in flow disruption) at 12-month follow-up. The mean modified Rankin Scale (mRS) before the procedure was 0.05±0.26 which was increased to 0.22±0.76 after the procedure, 0.22±0.76 at 6 months, and 0.30±0.95 at 12 months (P<0.001). Similar to previous studies, the present study demonstrates that neurovascular intervention can treat ruptured aneurysms as the first therapeutic modality with favourable outcomes. A double-blind, randomized clinical trial is needed to eliminate the confounding factors and better demonstrate the outcome.


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