KMID : 1005420190210040193
|
|
Journal of Cerebrovascular and Endovascular Neurosurgery 2019 Volume.21 No. 4 p.193 ~ p.196
|
|
A new definition for wide-necked cerebral aneurysms
|
|
Park Hyun-Seok
Kwon Soon-Chan Park Eun-Suk Park Jun-Bum Kim Min-Soo
|
|
Abstract
|
|
|
Background : Endovascular management of wide-necked aneurysms often requires assisted-techniques with adjunctive devices. Wide-necked aneurysm can be defined with a dome-to-neck ratio or aspect ratio; however, clinical definitions of wide-necked aneurysms vary. This study aimed to determine the most useful definition of wide-necked aneurysm to predict the need for an adjunctive device.
Methods : Among 552 cases of aneurysms, 343 (62.1%) and 209 (37.9%) cases of unruptured and ruptured aneurysms, respectively, were treated in a single institution. For each aneurysm, the (1) dome-to-neck ratio, (2) aspect ratio, and (3) K-ratio (defined as [dome height+maximum dome width]/[2¡¿maximum neck width]) were measured. We statistically analyzed patient data to determine which of the three ratios was most predictive of the need for adjunctive devices.
Results : Among 552 cases of aneurysms, 277 (50.2%) and 275 (49.8%) cases were treated with and without adjunctive techniques, respectively. The mean dome-to-neck ratio, aspect ratio, and K-ratio were 1.17¡¾0.39, 1.58¡¾0.61, and 1.37¡¾0.47, respectively. The K-ratio was the strongest predictor of the use of adjunctive devices (P<0.001), and 1.3 was the most appropriate K-ratio cut-off value (sensitivity, 72.9%; specificity, 63.6%).
Conclusions : K-ratio was the most useful predictor of the need for adjunctive devices in the treatment of endovascular aneurysms. These results suggest that the K-ratio may be used to define wide-necked aneurysms requiring complicated management via adjunctive devices.
|
|
KEYWORD
|
|
Intracranial aneurysm, Endovascular treatment, Wide-necked aneurysm, Definition
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|