Early and long-term results of endovascular treatment of cerebral aneurysms

Introduction. Postoperative angiographic examinations after endovascular treatment of cerebral aneurysms may demonstrate unstable results, both in the form of recurrence formation, and in the form of increased degree of occlusion with initially incomplete occlusion of the aneurysm sac. Cerebral aneurysm recurrences represent an important medical and social problem comparable in terms of hemorrhage risks with nonoperated aneurysms.

Aim. To estimate the early and long‑term results of endovascular treatment of patients with cerebral aneurysms ope rated on using different endovascular techniques. Materials and methods. The present study included 167 patients (48 men and 119 women) with 195 cerebral aneurysms aged from 18 to 75 years who were operated on using endovascular techniques at the neurosurgical department No. 3 of the Russian Research Neurosurgical Institute named after Prof. A. L. Polenov from 2013 to 2016. The average age of the patients was 52 ± 12 years, the minimum age was 18 years, and the maximum age was 75 years. The choice of endovascular treatment method in the patients included in the study was based on anatomico‑topographic and morphometric features of aneurysm, as well as taking into account the period of aneurysmal disease course.

Results. The study of data of control angiographic examinations after endovascular treatment of patients with cerebral aneurysms showed that in the remote postoperative period the degree of aneurysm occlusion may differ from that initially achieved. The probability of aneurysm recurrence after its isolated occlusion with coils may reach 13.1 % already in 6 months after surgical treatment, 31.7 % after 12 months and 22.3 % after 36 months, averaging 22.5 % (p < 0.05).

Conclusion. The personalized approach in choosing optimal surgical tactics for the treatment of patients with cerebral aneurysms allows to achieve stable radical aneurysm occlusion, to decrease the incidence of postoperative complications and aneurysm recurrences in the long‑term postoperative period.

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39. Вклад авторов В.В. Бобинов: проведение нейрохирургического лечения, написание и научное редактирование текста статьи; А.Е. Петров, С.А. Горощенко: проведение нейрохирургического лечения, научное редактирование текста статьи; Е.Г. Коломин, Н.К. Самочерных, Н.Ю. Туканов: сбор и обработка данных для написания статьи; Л.В. Рожченко, К.А. Самочерных: научное редактирование текста статьи. Author’s contribution V.V. Bobinov: neurosurgical treatment, writing and scientific editing of the article; A.E. Petrov, S.A. Goroshchenko: neurosurgical treatment, writing and scientific editing of the article; E.G. Kolomin, N.K. Samochernikh, N.Yu. Tukanov: collecting and processing data to write the article; L.V. Rozhenchenko, K.A. Samochernikh: scientific editing of the article.