Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Sep 19:84:e360-e364.
doi: 10.5114/pjr.2019.89159. eCollection 2019.

Safety and efficacy of treatment of very small intracranial aneurysms

Tomasz Jamróz  1 , Izabela Jakutowicz  1 , Mariusz Hofman  2 , Marta Kołodkiewicz  1 , Maciej Ćmiel  1 , Anna Łapaj  1 , Nikodem Przybyłko  3 , Piotr Bażowski  1 , Jan Baron  1
Affiliations

Safety and efficacy of treatment of very small intracranial aneurysms

Tomasz Jamróz et al. Pol J Radiol. .

Abstract

Purpose: Very small intracranial aneurysms (VSIAs) may cause many neurological complications and even death. Thanks to technological progress and higher quality of non-invasive neuroimaging methods, these pathologies can be investigated sooner and treated earlier. Due to the controversy surrounding invasive treatment of these pathologies, the aim of the study was to analyse methods of treatment, their outcome, and complications in a group of patients with VSIAs.

Material and methods: Out of 444 cases of intracranial aneurysms treated in our centre, 65 aneurysms met the radiological criteria of VSIAs. The parameters - width and length of the aneurysm's neck and width, length, and height of the aneurysm's dome - were measured. The analysed parameters were as follows: symptoms upon admission and after treatment, days in hospital, and intraoperative complications. Clinical and radiological intensity of subarachnoid haemorrhage (SAH) was evaluated by using the Hunt-Hess and Fisher scales. The degree of embolisation of the aneurysm after the procedure was assessed using the Montreal Scale. Clinical outcome was assessed by Glasgow Outcome Scale.

Results: 50.77% of VSIAs were treated with endovascular procedures and 49.23% with neurosurgical clipping. SAH was presented in 38.46% of patients with VSIAs. Intraoperative complications were presented in 16.92% of patients with VSIAs, and the most common complication was ischaemic stroke. Stents were used in 51.52% of VSIAs. In 69.70% of embolisation procedures at VSIAs complete obliteration was achieved. The average result in the Montreal Scale was 1.31 (SD = 0.66).

Conclusion: VSIAs can be treated as effectively and safely as larger aneurysms, by both endovascular and surgical methods.

Keywords: endovascular procedures; intracranial aneurysm; subarachnoid haemorrhage.

PubMed Disclaimer

Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Distribution of very small intracranial aneurysms
Figure 2
Figure 2
Patient outcomes in the Glasgow Outcome Scale (GOS)
See this image and copyright information in PMC

References

    1. Feng X, Ji W, Qian Z, et al. Bifurcation location is significantly associated with rupture of small intracranial aneurysms (<5 mm) World Neurosurg. 2017;98:538–545. - PubMed
    1. Mascitelli JR, Moyle H, Oermann EK, et al. An update to the Raymond-Roy Occlusion Classification of intracranial aneurysms treated with coil embolization. J Neurointerv Surg. 2015;7:496–502. - PubMed
    1. Jennett B, Bond M. Assessment of outcome after severe brain damage: a practical scale. Lancet. 1975;1:480–484. - PubMed
    1. Hunt WE, Hess RM. Surgical risk as related to time of intervention in the repair of intracranial aneurysms. J Neurosurg. 1968;28:14–20. - PubMed
    1. Fisher CM, Kistler JP, Davis JM. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by CT scanning. Neurosurgery. 1980;6:1–9. - PubMed