interventional neuroradiology colmar france

Transcription

Intra Cranial Aneurysms
Treatment with Hydrocoils :
7 year follow-up in a single
center experience
A . TOURNADE , MD
M.MUSACCHIO, MD , A . LEBEDINSKY , MD , N.HIROTA , MD
A. UEMURA , MD , T . TAJAHMADY , MD
Interventional neuroradiology colmar france
Hydrocoils: patient data
From may 2004 to september 2010
130 patients with 135 aneurysms underwent
evt with 385 hydrocoils (mean:2,8 hdc per
aneurysm)
Hydrogel Characteristics
Hydrated
Dehydrated
INTERVENTIONAL NEURORADIOLOGY COLMAR FRANCE
mc
Hydrocoil Embolic System
Hybrid hydrogel-platinun coil device:
a platinun coil covered with a compact hydrogel material
and an outer overcoil. The hydrogel expandes and the
device becames thicker.
Total outer diameter could achieve three times the initial
diameter .
mc
Hydrocoil Embolic System
Does it improve efficacy of aneurysm
endovascular treatment ?
Does it reduce recurrence, and so improve
durability of aneurysm endovascular
treatment ?
mc
Hydrocoils: patient data
130 patients : gender
Female : 61,44%
Male : 38,55%
130 patients : age
18 to 77 , mean : 47,5 years
Hydrocoils: patient clinical data
Patients n :130
Sah : 95 : 73,07%
No rupture : 35 : 26,92%
5 patients had multiple aneurysms : 3,84%
Hydrocoils: follow-up
Clinical and radiological follow-up :
1 month to 60 : mean time :30,5 months
At 3 month : angio,
At 6 month : MRangio,
At 1 year : MRangio till 5 years
Hydrocoils: aneurysms localisation
Internal carotid artery: n:42: 31,11%
Terminal :n :18 : 13,33%
Post –com. :n:16 : 11,85%
Carotido-ophtal. :n:8 :5,92%
Pericallosal artery :n: 5 : 3,70%
Hydrocoils: aneurysms localisation
Mid.cer.art.:n :30 :22,22%
Ant.cer.art.:n :12:8,88%
Basilar trunk:n :12 :8,88%
ant.com.art. :n :24 :17,77%
Hydrocoils: aneurysms size
N= 135 aneurysms
From 3 to 12mm
Mean size :7,5mm
Hydrocoils: embolization
Among 135 aneurysms : 12 using hdc only
They were small sized : 2 & 3 mm : 8,88%
With 135 aneurysms : 422 complex &
microplex coils and 38 specific frame
hydrocoils : 28,14%
Hydrocoils:evolution results
Aneurysms n: 135
11 reembolizations :8,14 %
7 small remnants remaining stable :5,18 %
No rebleeding
Hydrocoils:complications
1 protrusion with no clinical or angio
traduction
1 rupture per procedure : full embolization
and no consequences
No hydrocephalus or meningitis
Hydrocoils:discussion conclusions
Effectiveness: very good occlusion in a
short time
Stability :excellent stability with low
recurrence rate over 6 years
Safety: low morbi- mortality rate
Economy: less coils,time reducing
procedure
EVT WITH HYDROCOILS
EVT WITH HYDROCOILS
IMMEDIATE CONTROL
EVT WITH HYDROCOILS
6 MONTH - FOLLOW-UP
EVT WITH HYDROCOILS
1 YEAR - FOLLOW-UP
EVT WITH HYDROCOILS
18 MONTH - FOLLOW-UP
EVT WITH HYDROCOILS
2 YEAR - FOLLOW-UP
EVT WITH HYDROCOILS
LEFT PCO ANEURYSM : BARE-COILS EMBOLISATION
EVT WITH HYDROCOILS
6 MONTH- CONTROL
RE-EMBOLISATION : 3 HYDROCOILS
EVT WITH HYDROCOILS
RIGHT SIDE: ASYMPTOMATIC TOP-CAROTID AN
HYDROCOILS EMBOLISATION
EVT WITH HYDROCOILS
6 MONTH - FOLLOW-UP
1 YEAR - FOLLOW-UP
EVT WITH HYDROCOILS
BOTH SIDES : 2 YEAR - FOLLOW-UP
EVT WITH HYDROCOILS
EVT WITH HYDROCOILS
EVT WITH HYDROCOILS
EVT WITH HYDROCOILS
TWIN CAROTIDO-OPHTALMIC ANEURYSMS : LEFT SIDE
EVT WITH HYDROCOILS
RIGHT SIDE : LEO-STENT AND HYDROCOILS
EVT WITH HYDROCOILS
BOTH SIDES : 6 MONTH - CONTROL
EVT WITH HYDROCOILS
18 MONTH - CONTROL
2 YEAR - CONTROL
Hydrocoils:final conclusion
In our opinion considering the
improvement of the evt of intracranial
aneurysms during the recent years 2
tecnical devices appear powerful :
Hydrocoils and endoprothesis
MM
MM

interventional neuroradiology colmar france

Transcription

Similar documents