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Updated: May 28, 2026
11:58
Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Experience with coil embolization of previously clipped aneurysms presenting with rupture
Alejandro M Spiotta1, Albert Schuette, Ferdinand Hui
1Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Journal of Neurointerventional Surgery
|October 13, 2011
Summary
Rupture of previously clipped aneurysms is rare but can occur years later. Endovascular coil embolization offers a safe and effective treatment option for these recurrent ruptured aneurysms.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
Background:
- Endovascular coil embolization is a standard treatment for aneurysms, complementing microsurgical clipping.
- This study focuses on aneurysms previously treated with clipping that subsequently ruptured and were managed with coil embolization.
Purpose of the Study:
- To evaluate the safety and efficacy of endovascular coil embolization for treating previously clipped aneurysms that present with rupture.
Main Methods:
- A retrospective review of prospectively maintained databases from two institutions over 12 years.
- Identified seven patients with previously clipped aneurysms that ruptured and were treated with coil embolization.
Main Results:
- Six of seven patients had previously ruptured aneurysms, presenting a mean of 11.5 years post-clipping.
- Aneurysm locations varied, with most in the anterior communicating artery.
- Angiographic outcomes included complete occlusion in 42.9% and residual neck in 57.1%, with no intraprocedural complications.
Conclusions:
- Aneurysm rupture after surgical clipping is uncommon but can occur long after initial treatment.
- Endovascular embolization, with or without balloon assistance, is a safe and effective treatment for recurrent ruptured aneurysms post-clipping, yielding satisfactory angiographic results.
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