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Early and late microsurgical clipping for initially coiled intracranial aneurysms.

Authors
Chung, J; Lim, YC; Kim, BS; Lee, D; Lee, KS; Shin, YS
Citation
Neuroradiology, 52(12):1143-1151, 2010
Journal Title
Neuroradiology
ISSN
0028-39401432-1920
Abstract
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.
MeSH terms
AdolescentAdultAgedEmbolization, Therapeutic/instrumentation*Embolization, Therapeutic/statistics & numerical data*FemaleHumansIncidenceIntracranial Aneurysm/epidemiology*Intracranial Aneurysm/therapy*MaleMicrosurgery/statistics & numerical data*Middle AgedPrevalenceRecurrence/prevention & controlRepublic of Korea/epidemiologyRisk AssessmentRisk FactorsTreatment FailureTreatment OutcomeYoung Adult
DOI
10.1007/s00234-010-0695-4
PMID
20390259
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Neurosurgery
AJOU Authors
임, 용철
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