Early and late microsurgical clipping for initially coiled intracranial aneurysms

Introduction An increasing number of patients with incompletely treated and recurrent intracranial aneurysms are presenting for further management. We review the patients who underwent microsurgical clipping of previously coiled intracranial aneurysms. Methods From 2001 to 2008, we treated 623 aneur...

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Bibliographic Details
Published in:Neuroradiology 2010-12, Vol.52 (12), p.1143-1151
Main Authors: Chung, Joonho, Lim, Yong Cheol, Kim, Bum-soo, Lee, Dongwoo, Lee, Kwan-Sung, Shin, Yong Sam
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aneurysms
Biological and medical sciences
Brain
Cognition. Intelligence
Embolization, Therapeutic - instrumentation
Embolization, Therapeutic - statistics & numerical data
Female
Fundamental and applied biological sciences. Psychology
Humans
Imaging
Incidence
Interventional Neuroradiology
Intracranial Aneurysm - epidemiology
Intracranial Aneurysm - therapy
Investigative techniques, diagnostic techniques (general aspects)
Male
Medical imaging
Medical sciences
Medicine
Medicine & Public Health
Mental imagery. Mental representation
Microsurgery
Microsurgery - statistics & numerical data
Middle Aged
Nervous system
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Prevalence
Psychology. Psychoanalysis. Psychiatry
Psychology. Psychophysiology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiology
Republic of Korea - epidemiology
Risk Assessment
Risk Factors
Secondary Prevention
Surgical outcomes
Treatment Failure
Treatment Outcome
Young Adult
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Summary:Introduction An increasing number of patients with incompletely treated and recurrent intracranial aneurysms are presenting for further management. We review the patients who underwent microsurgical clipping of previously coiled intracranial aneurysms. Methods From 2001 to 2008, we treated 623 aneurysms by endovascular treatment. Among them, 29 patients underwent microsurgical clipping. Nineteen patients (group A) underwent early surgical intervention due to incomplete coiling, a residual neck, coil protrusion, aneurysm rupture, or coil stretching. Ten patients (group B) underwent surgical clipping for recurrent aneurysm and an increased mass effect during the follow-up period. The radiographic images and clinical data were reviewed retrospectively to determine the treatment efficacy, the clinical outcomes, and the factors that are important to select the proper treatment modality. Results There were 13 female and 16 male patients. The coils were removed in 6 of the 19 patients in group A and in 1 of the 10 patients in group B. Seventeen (89.5%) of the 19 patients in group A and all the patients (100%) in group B achieved good recovery (Glasgow Outcome Scale 5 and 4) during the clinical follow-up periods (mean 25.2 months). Conclusion Microsurgical clipping may be chosen as a safe and permanent treatment option for the previously coiled aneurysms with acceptable morbidity in properly selected cases.
ISSN:0028-3940
1432-1920
DOI:10.1007/s00234-010-0695-4