Parent Artery Occlusion Is Not Obsolete in Giant Aneurysms of the ICA. Experience With Very-Long-Term Follow-Up

Neuroradiology. 2011 Dec;53(12):973-82. doi: 10.1007/s00234-010-0800-8. Epub 2010 Dec 9.

Abstract

Introduction: The purpose of this study was to present the long-term clinical and angiographic follow-up (FU) in 26 consecutive patients with giant/large aneurysms (G/LAs) of the internal carotid artery (ICA) treated by parent artery occlusion (PAO).

Methods: Twenty-two of 26 G/LAs of the ICA were treated by PAO when a balloon test occlusion prior to occlusion of the ICA was tolerated. Clinical and angiographic FU were available in, respectively, 20 and 18 patients with a mean delay of 6.1 years (range 1.5-11).

Results: At long-term FU, clinical symptoms had disappeared in 75% of the patients, partially regressed in 10%, and remained unchanged in 15% of cases. No patient presented worsening of clinical symptoms or intracranial bleeding. Fifteen patients presented a modified Rankin scale score of 0 and five patients a score of 1. On imaging FU, persistent occlusion of the PA was observed in 17/18 cases. One case of aneurysmal recanalization was observed at long-term FU. PAO was well tolerated in all patients. On angiographic FU, no new lesion was detected, except the growing of a pre-existing aneurysm located on the carotid siphon contralateral to the occluded vessel.

Conclusion: Our study demonstrates that occlusion of the parent artery for giant/large ICA aneurysms remains a safe and effective technique with good clinical and angiographic outcome at long-term FU.

MeSH terms

  • Adult
  • Aged
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / therapy*
  • Endovascular Procedures / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / diagnostic imaging*
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Radiography, Interventional / methods*
  • Therapeutic Occlusion / methods*
  • Treatment Outcome
  • Young Adult