Efficacy and Safety of Endovascular Embolization Treatment of Middle Cerebral Artery Aneurysms

Objective To investigate the feasibility,effectiveness and safety of endovascular embolization treatment of middle cerebral artery aneurysms. Methods 65 patients with middle cerebral artery aneurysm treated by endovascular embolization in Department of Neurosurgery,the First Hospital of Hebei Medical University between June 2005 and October 2013 were enrolled,including 21 subjects by simply embolization with coils,15 by balloon assisted remodeling technique and coils,12 by embolization with stents and coils and 17 by simply implantation of stents. Their imaging data,aneurysm site,treatment method and result,operative complications,follow- up 3 months after operation were analyzed retrospectively. A modified Rankin Scale was used both for recovery measurement of patients' nerve function. Results 65 cases of cerebral artery aneurysms,43 aneurysms located in the M1 segment,22 in the middle cerebral artery bifurcation; 12 patients had unruptured aneurysms and cerebral and CT scan showed circular high density in lateral fissure area while 53 patients had ruptured aneurysms manifested as typical subarachnoid hemorrhage under CT scan. Endovascular embolization operation was successful in all patients. Immediate postoperative angiography showed dense embolism in 46 cases,5 cases of developing cervical tumors and 14 cases of tumor development. No cases died during peri- operative period. 4 had complications and 1 underwent intraoperative rupture. After quickly complete embolization of aneurysm therapy,the relevant symptoms of the patients disappeared; 1 case had a transient weakness after three days; 1 case underwent rapture again one week after operation and improved after treatment by surgical debridement; 1case with aneurysms located in MCA had cerebral infarction 4 days after balloon- assisted embolization. DSA check 3 months after operation showed that progress in 15 cases receiving embolization treatment again; 27 patients no progress. MRS score was 0 in 45 cases,1 in 14 cases,2 in 4 cases,4 in 2 cases at follow- up after 3 months. Conclusion Endovascular embolization treatment of cerebral aneurysms is a safe and effective method.