Endovascular treatment of posterior communicating artery aneurysms with oculomotor nerve palsy: Clinical outcomes and predictors of nerve recovery

N. Chalouhi, T. Theofanis, P. Jabbour, A. S. Dumont, L. F. Gonzalez, R. M. Starke, D. Gordon, R. Rosenwasser, S. Tjoumakaris

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

BACKGROUND AND PURPOSE: ONP is a well-known presentation of PcomA aneurysms. Reports on recovery of ONP with endovascular coiling have been limited to small case series. We assessed the safety and efficacy of endovascular therapy in a series of PcomA aneurysms with ONP. MATERIALS AND METHODS: We reviewed 37 patients with ONP who underwent endovascular treatment in our institution between 2005 and 2011. Published studies were also reviewed to determine the overall rate of ONP recovery with endovascular therapy. RESULTS: Nineteen patients (51.4%) presented with complete ONP, and 18 (48.6%), with partial ONP. Conventional coiling was performed in 31 (83.8%) patients; stent-assisted coiling, in 4 (10.8%); and balloon remodeling, in 2 (5.4%). There was 1 (2.7%) procedural complication (a transient thromboembolic event). Twenty-seven (73%) patients were treated within 3 days from symptom onset. At the last available clinical follow-up, ONP resolution was complete in 14 (37.8%) patients and partial in 19 (51.4%). Only 4 (10.8%) patients showed no signs of nerve recovery. In multivariate analysis, partial ONP and longer follow-up durations were predictors of complete nerve recovery. Treatment timing, type of endovascular embolization, subarachnoid hemorrhage, and initial degree of aneurysm occlusion were not predictors of nerve recovery. Of 169 patients reported in the literature (including ours), ONP resolved completely in 73 (43.2%) patients and partially in 73 (43.2%). CONCLUSIONS: Endovascular therapy is a safe and highly efficient alternative to surgical clipping for PcomA aneurysms with ONP.

Original languageEnglish (US)
Pages (from-to)828-832
Number of pages5
JournalAmerican Journal of Neuroradiology
Volume34
Issue number4
DOIs
StatePublished - Apr 2013
Externally publishedYes

Fingerprint

Oculomotor Nerve Diseases
Intracranial Aneurysm
Aneurysm
Therapeutics
Subarachnoid Hemorrhage
Stents
Multivariate Analysis
Safety

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging

Cite this

Endovascular treatment of posterior communicating artery aneurysms with oculomotor nerve palsy : Clinical outcomes and predictors of nerve recovery. / Chalouhi, N.; Theofanis, T.; Jabbour, P.; Dumont, A. S.; Gonzalez, L. F.; Starke, R. M.; Gordon, D.; Rosenwasser, R.; Tjoumakaris, S.

In: American Journal of Neuroradiology, Vol. 34, No. 4, 04.2013, p. 828-832.

Research output: Contribution to journalArticle

Chalouhi, N, Theofanis, T, Jabbour, P, Dumont, AS, Gonzalez, LF, Starke, RM, Gordon, D, Rosenwasser, R & Tjoumakaris, S 2013, 'Endovascular treatment of posterior communicating artery aneurysms with oculomotor nerve palsy: Clinical outcomes and predictors of nerve recovery', American Journal of Neuroradiology, vol. 34, no. 4, pp. 828-832. https://doi.org/10.3174/ajnr.A3294
Chalouhi, N. ; Theofanis, T. ; Jabbour, P. ; Dumont, A. S. ; Gonzalez, L. F. ; Starke, R. M. ; Gordon, D. ; Rosenwasser, R. ; Tjoumakaris, S. / Endovascular treatment of posterior communicating artery aneurysms with oculomotor nerve palsy : Clinical outcomes and predictors of nerve recovery. In: American Journal of Neuroradiology. 2013 ; Vol. 34, No. 4. pp. 828-832.
@article{59249d18240c4b509a4d14b0812f63b8,
title = "Endovascular treatment of posterior communicating artery aneurysms with oculomotor nerve palsy: Clinical outcomes and predictors of nerve recovery",
abstract = "BACKGROUND AND PURPOSE: ONP is a well-known presentation of PcomA aneurysms. Reports on recovery of ONP with endovascular coiling have been limited to small case series. We assessed the safety and efficacy of endovascular therapy in a series of PcomA aneurysms with ONP. MATERIALS AND METHODS: We reviewed 37 patients with ONP who underwent endovascular treatment in our institution between 2005 and 2011. Published studies were also reviewed to determine the overall rate of ONP recovery with endovascular therapy. RESULTS: Nineteen patients (51.4{\%}) presented with complete ONP, and 18 (48.6{\%}), with partial ONP. Conventional coiling was performed in 31 (83.8{\%}) patients; stent-assisted coiling, in 4 (10.8{\%}); and balloon remodeling, in 2 (5.4{\%}). There was 1 (2.7{\%}) procedural complication (a transient thromboembolic event). Twenty-seven (73{\%}) patients were treated within 3 days from symptom onset. At the last available clinical follow-up, ONP resolution was complete in 14 (37.8{\%}) patients and partial in 19 (51.4{\%}). Only 4 (10.8{\%}) patients showed no signs of nerve recovery. In multivariate analysis, partial ONP and longer follow-up durations were predictors of complete nerve recovery. Treatment timing, type of endovascular embolization, subarachnoid hemorrhage, and initial degree of aneurysm occlusion were not predictors of nerve recovery. Of 169 patients reported in the literature (including ours), ONP resolved completely in 73 (43.2{\%}) patients and partially in 73 (43.2{\%}). CONCLUSIONS: Endovascular therapy is a safe and highly efficient alternative to surgical clipping for PcomA aneurysms with ONP.",
author = "N. Chalouhi and T. Theofanis and P. Jabbour and Dumont, {A. S.} and Gonzalez, {L. F.} and Starke, {R. M.} and D. Gordon and R. Rosenwasser and S. Tjoumakaris",
year = "2013",
month = "4",
doi = "10.3174/ajnr.A3294",
language = "English (US)",
volume = "34",
pages = "828--832",
journal = "American Journal of Neuroradiology",
issn = "0195-6108",
publisher = "American Society of Neuroradiology",
number = "4",

}

TY - JOUR

T1 - Endovascular treatment of posterior communicating artery aneurysms with oculomotor nerve palsy

T2 - Clinical outcomes and predictors of nerve recovery

AU - Chalouhi, N.

AU - Theofanis, T.

AU - Jabbour, P.

AU - Dumont, A. S.

AU - Gonzalez, L. F.

AU - Starke, R. M.

AU - Gordon, D.

AU - Rosenwasser, R.

AU - Tjoumakaris, S.

PY - 2013/4

Y1 - 2013/4

N2 - BACKGROUND AND PURPOSE: ONP is a well-known presentation of PcomA aneurysms. Reports on recovery of ONP with endovascular coiling have been limited to small case series. We assessed the safety and efficacy of endovascular therapy in a series of PcomA aneurysms with ONP. MATERIALS AND METHODS: We reviewed 37 patients with ONP who underwent endovascular treatment in our institution between 2005 and 2011. Published studies were also reviewed to determine the overall rate of ONP recovery with endovascular therapy. RESULTS: Nineteen patients (51.4%) presented with complete ONP, and 18 (48.6%), with partial ONP. Conventional coiling was performed in 31 (83.8%) patients; stent-assisted coiling, in 4 (10.8%); and balloon remodeling, in 2 (5.4%). There was 1 (2.7%) procedural complication (a transient thromboembolic event). Twenty-seven (73%) patients were treated within 3 days from symptom onset. At the last available clinical follow-up, ONP resolution was complete in 14 (37.8%) patients and partial in 19 (51.4%). Only 4 (10.8%) patients showed no signs of nerve recovery. In multivariate analysis, partial ONP and longer follow-up durations were predictors of complete nerve recovery. Treatment timing, type of endovascular embolization, subarachnoid hemorrhage, and initial degree of aneurysm occlusion were not predictors of nerve recovery. Of 169 patients reported in the literature (including ours), ONP resolved completely in 73 (43.2%) patients and partially in 73 (43.2%). CONCLUSIONS: Endovascular therapy is a safe and highly efficient alternative to surgical clipping for PcomA aneurysms with ONP.

AB - BACKGROUND AND PURPOSE: ONP is a well-known presentation of PcomA aneurysms. Reports on recovery of ONP with endovascular coiling have been limited to small case series. We assessed the safety and efficacy of endovascular therapy in a series of PcomA aneurysms with ONP. MATERIALS AND METHODS: We reviewed 37 patients with ONP who underwent endovascular treatment in our institution between 2005 and 2011. Published studies were also reviewed to determine the overall rate of ONP recovery with endovascular therapy. RESULTS: Nineteen patients (51.4%) presented with complete ONP, and 18 (48.6%), with partial ONP. Conventional coiling was performed in 31 (83.8%) patients; stent-assisted coiling, in 4 (10.8%); and balloon remodeling, in 2 (5.4%). There was 1 (2.7%) procedural complication (a transient thromboembolic event). Twenty-seven (73%) patients were treated within 3 days from symptom onset. At the last available clinical follow-up, ONP resolution was complete in 14 (37.8%) patients and partial in 19 (51.4%). Only 4 (10.8%) patients showed no signs of nerve recovery. In multivariate analysis, partial ONP and longer follow-up durations were predictors of complete nerve recovery. Treatment timing, type of endovascular embolization, subarachnoid hemorrhage, and initial degree of aneurysm occlusion were not predictors of nerve recovery. Of 169 patients reported in the literature (including ours), ONP resolved completely in 73 (43.2%) patients and partially in 73 (43.2%). CONCLUSIONS: Endovascular therapy is a safe and highly efficient alternative to surgical clipping for PcomA aneurysms with ONP.

UR - http://www.scopus.com/inward/record.url?scp=84876743837&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84876743837&partnerID=8YFLogxK

U2 - 10.3174/ajnr.A3294

DO - 10.3174/ajnr.A3294

M3 - Article

C2 - 23042929

AN - SCOPUS:84876743837

VL - 34

SP - 828

EP - 832

JO - American Journal of Neuroradiology

JF - American Journal of Neuroradiology

SN - 0195-6108

IS - 4

ER -