Extrasacular methods for the treatment of arterial aneurysms of vessels of the brain

Abstract

Objective — to determine the efficacy of extrasacular methods of arterial aneurysm deactivation.
Materials and methods. During the period from 2011 to 2018 86 patients with arterial aneurysms of the brain were examined and treated using extratrasacular methods, among them were 54 (62.8 %) women. The average age of patients was 49.7 year. 70 (81.4 %) patients had saccular aneurysm and 16 (18.6 %) had fusiform aneurysm.
Results. 86 patients were operated on. In 3 (3.5 %) cases to use deconstructive shutdown, in 83 (96.5 %) — reconstructive. In 69 patients, surgery was performed in the «cold» period of the disease. The number of all complications that led to death was 3 (3.5 %) cases, among which 2 (2.4 %) this complication was not associated with the operation (severe concomitant pathology). The control examination was performed on 41 (47.7 %) patients; they were performed in terms of 6 months, 6–12 months, more than 12 months. A follow-up examination of 35 patients with AI, and 6 patients (37.5 %) with FA was performed. With MA 1, the type of shutdown on the modified Raymond–Roy scale after 12 months was noted in 77 % of observations, type 2 — in 9 %, and type 3 — in 14 %, with FA full shutdown — in 33 %, type 3 — in 67 % cases. Thrombosis of the bearing artery was found in 3 (3.5 %) patients, stenosis at the stent level in 4 (4.7 %). In all these cases the complications were asymptomatic.
Conclusions. Extrasaccular endovascular methods of treating arterial aneurysms of the cerebral vessels are effective and relatively safe. They allow to expand the indications for endovascular treatment of giant, partially thrombosed and spindle-shaped aneurysms. To use of extrasaccular techniques it was possible to achieve a complete shutdown in 77 % aneurysms of a complex shape.