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Endovascular treatment of unruptured intracranial aneurysms shows short-term success in a high percentage of patients, French researchers report in the September issue of Stroke.

Endovascular treatment of unruptured intracranial aneurysms shows short-term success in a high percentage of patients, French researchers report in the September issue of Stroke.

Dr. Laurent Pierot of Hopital Maison-Blanche, Reims, and colleagues note that the management of such patients remains controversial and the results of endovascular treatment are not precisely known.

To shed more light on the matter, the researchers prospectively followed 649 patients with 1100 aneurysms. Overall, 739 aneurysms were treated in a total of 700 procedures.

Most (54.5 per cent) treatments involved coils alone, followed by the balloon remodeling technique (37.3 per cent) and stenting (7.8 per cent).

The treatment failed in 32 aneurysms and there were technical adverse events in 100 patients (15.4 per cent).

Among the 649 patients, 35 adverse events (5.4 per cent of patients) occurred involving 12 transient neurological deficits, 17 permanent neurological deficits, and six deaths.

At one month, the morbidity rate was 1.7 per cent and the mortality rate was 1.4 per cent. Mortality was due mainly to intraoperative rupture and thromboembolic complications. Thromboembolic complications were the leading cause of morbidity.

The researchers note that results will be further examined at one and three years of follow-up. However, Dr. Pierot told Reuters Health that the study "demonstrates that the endovascular treatment of unruptured intracranial aneurysms is feasible in a high percentage of cases with a low morbidity and mortality. Accordingly, the endovascular approach is in our opinion the first line treatment when a treatment is decided."

Stroke 2008;39:2497-2504