Microsurgical treatment for the recurrent cerebral aneurysm initially treated using coil embolization

Area of Science:

• Neurosurgery
• Endovascular Surgery
• Cerebrovascular Disease

Background:

• Recurrent cerebral aneurysms after coil embolization pose a significant clinical challenge.
• Endovascular coiling may result in residual necks, coil compaction, or aneurysm regrowth.

Purpose of the Study:

• To evaluate the safety and efficacy of microsurgical treatment for recurrent cerebral aneurysms previously treated with coil embolization.

Main Methods:

• A retrospective review of 34 patients who underwent microsurgical treatment for recurrent cerebral aneurysms from June 2012 to May 2019.
• Analysis included aneurysm location, reasons for retreatment, surgical techniques, and outcomes.

Main Results:

• Most recurrent aneurysms were in the anterior circulation, commonly at the anterior communicating artery.
• Reasons for microsurgery included rebleeding (12 cases) and recurrence (21 cases).
• Microsurgical techniques included neck clipping and clipping with coil mass extraction; bypass was used for blister-like aneurysms. Good outcomes were associated with patient age, cause of retreatment, and pre-operative modified Rankin Scale score.

Conclusions:

• Microsurgical intervention is a viable and effective treatment for recurrent cerebral aneurysms post-coil embolization.
• The study demonstrates successful management of complex recurrent aneurysms with microsurgery, with no severe complications reported in follow-up.