Türk Nöroşirürji Dergisi 2003 , Vol 13 , Num 1
Süleyman MEN5, M. Halil ÖZTÜRK1, M. Murat FIRAT2, Saruhan ÇEKİRGE2, Hakan SEÇKİN3, Ahmet ACIDUMAN4, Zafer KARS3, Zeki ŞEKERCİ4, Baki HEKİMOĞLU1
1SSK Ankara Hastanesi, Radyoloji Kliniği, Dışkapı, Ankara
2Hacettepe Üniversitesi, Radyodiagnostik A.B.D, Sıhhıye, Ankara
3SSK Ankara Eğitim Hastanesi, 2. Beyin Cerrahisi Kliniği, Dışkapı, Ankara
4SSK Ankara Eğitim Hastanesi,I. Beyin Cerrahisi Kliniği, Dışkapı, Ankara
5Dokuz Eylül Üniversitesi, Radyodiagnostik A.B.D., İnciraltı, İzmir
Twenty-one patients with aneurysms that are inappropriate for surgery have been treated by endovascular approach. To prevent the bleeding, either the aneurysm was filled with electrically detached microcoils or the harboring parent artery segment the aneurysm was occluded. The parent artery occlusion was preferred when the aneurysm was fusiform or its neek was too wide for endosaccular embolization. The parent artery occlusion was performed with detachable latex balloons. A 30-minute test occlusion was done before the baloon was detached permanently. Fifteen patients were treated with endosaccular coil embolization where the remaining 6 were treated with parent artery occlusion. The aneurysms treated with microcoil embolization included carotid ophthalmic (n=6), basilar tip (n=2), basilar fenestration (n=l), posterior communicating (n=l), middle cerebral arter bifurcation (n=l), superior hypophysial artery (n=1), paraclinoid (n=1), carotid bifurcation (n=l), and vertebro-basilar junction aneurysm (two aneurysms in one patient). Coil embolization was technically succesful in all but two patients. Parent artery occlusion was tolerated by all 6 patients. Overall, the complications included major posterior cerebral artery territory infaret in two patients one of whom died subsequently and the other developed permenant hemiparesis. There was temporary monoparesis in one patient, and silent watershed infaret in another following parent artery occlusion. No patient developed subaraehnoid hemorrhage during the follow-up (3-72 months). Our results suggest that endovascular treatment is an effectiye alternative method when surgery is infavorable in treatment of cerebral aneurysms. Anahtar Kelimeler : Cerebral aneurysm, endovascular therapy