ORIGINAL
Introdução: A artéria cerebral média (ACM) revela formações aneurismáticas, podendo se manifestar de forma única ou múltipla ao longo de seu leito, havendo fatores predisponentes para seu desenvolvimento e sítios prevalentes. Através da abordagem endovascular é possível realizar um tratamento mais delicado, assim como a ocorrência de complicações. Dessa forma, a triagem destes aneurismas na população alvo é relevante para a sobrevida destes pacientes. Objetivo: Analisar casos de pacientes com aneurisma de artéria cerebral média tratados por método endovascular em serviço de referência. Métodos: Estudo observacional retrospectivo com abordagem quantitativa de 368 pacientes com aneurismas de ACM submetidos a tratamento endovascular em serviço de neurocirurgia endovascular no período de 2005 a 2023. Resultados: O sexo feminino foi o mais acometido (73,91%), de meia idade (55,1 anos), com hipertensão arterial (74,18%). Prevaleceu o aneurisma sacular pequeno (94,29% / 83,97%) na bifurcação da ACM (79,89%), predominantemente não rotos (64,67%) correspondendo a escala de Fisher 1 e Grau 0 na escala de Hunt & Hess. A abordagem endovascular foi o procedimento de escolha em que a utilização de Coils prevaleceu (70,65%). Conclusão: Pacientes do sexo feminino, de meia idade, com hipertensão devem ser investigadas quanto a presença de doença aneurismática em ACM, uma vez que a probabilidade de não rotura é incerta, e a abordagem destas pacientes deve ter como foco o tratamento endovascular por ser uma conduta segura, com baixas taxas de insucesso, a fim da manutenção da vida destes.
Introduction: The middle cerebral artery (MCA) can develop aneurysmal formations, which may occur as single or multiple along its course, influenced by predisposing factors and prevalent sites. Endovascular approaches allow for more delicate treatments, though they also carry the risk of complications. Therefore, screening these aneurysms in target populations is crucial for patient survival. Objective: To analyze cases of patients with middle cerebral artery aneurysms treated using the endovascular method in a specialized center. Methods: A retrospective observational study with a quantitative approach, including 368 patients with MCA aneurysms treated with endovascular techniques in an endovascular neurosurgery center from 2005 to 2023. Results: The female gender was most affected (73.91%), with a mean age of 55.1 years, and a significant prevalence of hypertension (74.18%). Small saccular aneurysms (94.29% / 83.97%) were most common, predominantly located at the MCA bifurcation (79.89%) and mostly unruptured (64.67%), corresponding to Fisher Grade 1 and Hunt & Hess Grade 0. Endovascular intervention was the treatment of choice, with coil embolization being the predominant technique (70.65%). Conclusion: Female, middle-aged, hypertensive patients should be investigated for the presence of MCA aneurysmal disease, as the probability of rupture is uncertain. The treatment focus should be on endovascular procedures, which are safe and have low failure rates, ensuring better survival outcomes.
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2Fundação Universidade Regional de Blumenau (FURB), Blumenau - Santa Catarina, Brazil
3Universidade Regional de Blumenau (Medicine), Blumenau - Santa Catarina, Brazil
2Fundação Universidade Regional de Blumenau (FURB), Blumenau - Santa Catarina, Brazil
3Universidade Regional de Blumenau (Medicine), Blumenau - Santa Catarina, Brazil
