Six cases of ruptured aneurysm, treated with cellulose acetate polymer

We review 6 cases of ruptured aneurysm which were elderly, poor-grade SAH or requiring high-risk surgery treated with Cellulose Acetate Polymer (CAP). A 76-year-old female with A-com aneurysm was comatose. Heart failure was her complication (case 1). An 81-year-old female with A-com aneurysm was semicomatose (case 2). An 89-year-old female with MCA aneurysm was semicomatose and had right hemiplegia (case 3). An 88-year-old female with MCA aneurysm was comatose (case 4). A 55-year-old male with IC-PC aneurysm had a small intracerebral hematoma and was semicomatose (case 5). A 52-year-old female with IC-Ach aneurysm was somnolent (case 6). All cases had no rebleeding after embolization. CAP embolization was complete in all cases but case 1. Case 4 died from primary brain damage on the day 7. Three cases stayed in a severely disabled state and died after 3 months (case 1), 2 months (case 2) and 4 months (case 3) from onset respectively. Case 5 remains in a moderately disabled state after 2 years. Case 6 had a anterior choroidal artery which was hard to spare on aneurysmal clipping. She is free from neurological deficits after CAP embolization. Angiography after 2 years demonstrated complete obstruction of the aneurysm. CAP is good for cases which are elderly, poorgrade SAH or difficult to treat with surgery. CAP embolization has some advantages over GDC coil obstruction for aneurysm treatment.