Study finds low risk in treating previously coile...(the alternative technique of coiling. Du...),Health

Date:8/20/2009

the alternative technique of coiling. During a coiling procedure, a surgeon threads a flexible catheter from the large femoral artery near the groin up to one of four arteries in the neck that lead to the brain. The surgeon then advances platinum coils through small tubing into the aneurysm. The compacted coils are designed to block blood flow and prevent the aneurysm from bleeding.

The Food and Drug Administration originally approved coiling as a treatment for aneurysms that could not be surgically clipped, but over time endovascular coiling has emerged as a first-line option for surgically accessible aneurysms as well.

The retreatment study, Ringer says, supports an emerging consensus among neurosurgeons that retreatment is no longer a deterrent to the coiling of brain aneurysms. Of the 311 patients who underwent one or more retreatments, three died and one developed a major and permanent neurological disability. One patient suffered a significant neurological symptom that was transient, and four suffered a permanent minor symptom.

By comparison, previous studies of coiling and clipping cases have shown that the initial treatment for an unruptured aneurysm results in death or any disability 8 to 10 percent of the time. (Statistics of cases performed by Mayfield Clinic neurosurgeons, presented at national meetings, show that death or permanent disability occurs in only 3 percent of patients.) An untreated aneurysm of average size (7 to 12 mm), meanwhile, carries a mortality risk of 2.6 percent over five years. The risk of death from an untreated, ruptured aneurysm is much higher, with recurrent hemorrhage occurring in 50 percent of patients over a period of 6 months.

In the retreatment study Ringer collaborated with colleagues from the Endovascular Neurosurgery Research Group, which includes specialists from the University of Illinois at Peoria, Thomas Jefferson University (Philadelphia), the University of Puerto Rico, Vanderbi
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Contact: Cindy Starr cstarr@mayfieldclinic.com 513-558-3505 University of Cincinnati Academic Health Center Source:Eurekalert

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