Preoperative Coiling of Coexisting Intracranial Aneurysm and Subsequent Brain Tumor Surgery.
10.3348/kjr.2016.17.6.931
- Author:
Keun Young PARK
1
;
Byung Moon KIM
;
Dong Joon KIM
Author Information
1. Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea.
- Publication Type:Original Article
- Keywords:
Brain tumor;
Aneurysm;
Coexistence;
Treatment strategy;
Coiling;
Coil embolization
- MeSH:
Aneurysm;
Anterior Cerebral Artery;
Basilar Artery;
Brain Neoplasms*;
Brain*;
Carotid Artery, Internal;
Embolization, Therapeutic;
Follow-Up Studies;
Glioma;
Humans;
Intracranial Aneurysm*;
Ischemic Attack, Transient;
Meningioma;
Middle Cerebral Artery;
Neck;
Neuroma, Acoustic;
Pituitary Neoplasms;
Posterior Cerebral Artery;
Retrospective Studies
- From:Korean Journal of Radiology
2016;17(6):931-939
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Few studies have investigated treatment strategies for brain tumor with a coexisting unruptured intracranial aneurysm (cUIA). The purpose of this study was to evaluate the safety and efficacy of preoperative coiling for cUIA, and subsequent brain tumor surgery. MATERIALS AND METHODS: A total of 19 patients (mean age, 55.2 years; M:F = 4:15) underwent preoperative coiling for 23 cUIAs and subsequent brain tumor surgery. Primary brain tumors were meningiomas (n = 7, 36.8%), pituitary adenomas (n = 7, 36.8%), gliomas (n = 3, 15.8%), vestibular schwannoma (n = 1, 5.3%), and Rathke's cleft cyst (n = 1, 5.3%). cUIAs were located at the distal internal carotid artery (n = 9, 39.1%), anterior cerebral artery (n = 8, 34.8%), middle cerebral artery (n = 4, 17.4%), basilar artery top (n = 1, 4.3%), and posterior cerebral artery, P1 segment (n = 1, 4.3%). The outcomes of preoperative coiling of cUIA and subsequent brain tumor surgery were retrospectively evaluated. RESULTS: Single-microcatheter technique was used in 13 cases (56.5%), balloon-assisted in 4 cases (17.4%), double-microcatheter in 4 cases (17.4%), and stent-assisted in 2 cases (8.7%). Complete cUIA occlusion was achieved in 18 cases (78.3%), while residual neck occurred in 5 cases (21.7%). The only coiling-related complication was 1 transient ischemic attack (5.3%). Neurological deterioration did not occur in any patient during the period between coiling and tumor surgery. At the latest clinical follow-up (mean, 29 months; range, 2–120 months), 15 patients (78.9%) had favorable outcomes (modified Rankin Scale, 0–2), while 4 patients (21.1%) had unfavorable outcomes due to consequences of brain tumor surgery. CONCLUSION: Preoperative coiling and subsequent tumor surgery was safe and effective, making it a reasonable treatment option for patients with brain tumor and cUIA.
