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[Two cases with coil embolization following incomplete neck clipping].

H Kawamoto1, T Inagawa, F Ikawa

  • 1Department of Neurosurgery, Shimane Prefectural Central Hospital, Himebara-cho, Izumo, Shimane 693-8555, Japan.

No Shinkei Geka. Neurological Surgery
|February 24, 2001
PubMed
Summary

Coil embolization effectively treated residual brain aneurysms after incomplete neck clipping in two patients. Morphological features of the residual aneurysm are key to deciding on this endovascular procedure.

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Area of Science:

  • Neurosurgery
  • Interventional Neuroradiology
  • Vascular Neurology

Background:

  • Cerebral aneurysms, particularly those involving the internal carotid posterior communicating artery, pose a significant risk of subarachnoid hemorrhage.
  • Incomplete neck clipping can lead to residual aneurysms, necessitating further treatment.
  • Endovascular techniques offer an alternative or adjunctive treatment modality for complex cerebrovascular lesions.

Observation:

  • Two patients with subarachnoid hemorrhage due to ruptured internal carotid posterior communicating aneurysms underwent initial neck clipping.
  • Follow-up angiography revealed residual aneurysms in both cases: one involving the dome and the other near the neck.
  • Coil embolization using Guglielumi detachable coils was performed for the residual aneurysms.

Findings:

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  • Coil embolization achieved almost complete obliteration of the residual aneurysms in both cases.
  • The obliteration was sustained during follow-up periods of two and a half years and seven months, respectively.
  • Both patients were discharged with good functional status, indicating successful treatment outcomes.

Implications:

  • Coil embolization is a viable and effective treatment for residual cerebral aneurysms following incomplete surgical clipping.
  • The morphological characteristics of the residual aneurysm are crucial for determining the optimal timing and approach for endovascular intervention.
  • This approach can lead to favorable patient outcomes and improved functional status after cerebrovascular events.