Endovascular Treatment of Cerebral Aneurysms at a Low-Volume Institution: A Viable Alternative? (original) (raw)

2012, Journal of Neuroimaging

The advances of the endovascular techniques observed in the past two decades has made this surgical alternative, previously recommended only for aneurysms with no indication to be treated by conventional surgical technique (clipping), into a first choice approach for a large number of cerebral aneurysms in some services 1-3 . One of the main advances in these techniques was the advent of detachable plat-inum coils termed Guglielmi detachable coils (GDC). The development of coils with a better capacity to conform to aneurysms, quicker and safer detachable mechanisms and the use of bioactive materials in addition to coils are responsible for the higher rate currently obtained in aneurysm occlusion 4 . The development of the remodeling techniques, the use of intracranial stents and of liquid embolic ma-ABSTRACT -Objective: To present the results of cerebral aneurysms treated by endovascular technique. Method: Retrospective analysis of patient files of Hospital Geral de Fortaleza, Brazil. Results: We report the results of 163 cerebral aneurysms treated by endovascular techniques from January 2002 to October 2005. Patients with ruptured aneurysms (87.2%), according to Hunt-Hess scale were: 33.7% HH I, 28.4% HH II, 24.1% HH III, 13.8% HH IV. The Fisher scale grade IV was the most common (39.7%). Remodeling, coil embolization, arterial occlusion and histoacryl embolization were the techniques employed. Effective occlusion was achieved in 87.7%, partial occlusion in 5.3% and non-effective occlusion in 7.0% of the patients. Glasgow outcome scale results were: 76.3% GOS 5, 5.0% GOS 4, 5.8% GOS 3, 1.4% GOS 2 and 11.5% GOS 1. Conclusion: Endovascular treatment seems to be feasible within Brazilian public health system, with results as good as those obtained in larger international centers.