Trends in Neurovascular Interventions

Hiroshi Tenjin, Seisuke Tanigawa, Michiko Takadou, Takahiro Ogawa, Ayako Mandai, Masataka Nannto, Yasuhiko Osaka, Yoshikazu Nakahara, Tenjin, Hiroshi, Tanigawa, Seisuke, Takadou, Michiko, Ogawa, Takahiro, Mandai, Ayako, Nannto, Masataka, Osaka, Yasuhiko, Nakahara, Yoshikazu

Recent technological progress has reduced the complication rate of unruptured aneurysm. We treated 128 unruptured aneurysms between April 2006 and March 2012. Seventy-six aneurysms (59 %) were clipped and 52 (41 %) were coil embolized. After 2010, we applied new instruments, i.e., near-infrared indocyanine-green videoangiography (ICG), an intraoperative endoscope, preoperative detailed MRI, and a stent-assisted coil embolization. In the results: (1) In 60 aneurysms treated before 2009, three patients showed a deterioration of more than two points in mRS (5 %). In 68 aneurysms treated after 2010, no patients showed deterioration (0 %) (p: n.s.). (2) No patients died and 126 patients (98 %) were discharged to home directly. (3) No patients showed rupture after treatment. In conclusion, the appropriate selection of treatment and recent technological progress have facilitated sophisticated treatment of unruptured aneurysms. Recently, the complication rate in surgery and endovascular surgery for unruptured aneurysms has become acceptably low.