Microsurgical management of previously embolized intracranial aneurysms: A single center experience and literature review
10.7461/jcen.2024.E2024.05.004
- Author:
Vasileios PANAGIOTOPOULOS
1
;
Ioannis Panagiotis ATHINODOROU
;
Kyprianos KOLIOS
;
Constantinos KATTOU
;
Andreas GRZECZINSKI
;
Andreas THEOFANOPOULOS
;
Lambros MESSINIS
;
Constantine CONSTANTOYANNIS
;
Petros ZAMPAKIS
Author Information
1. Department of Neurosurgery, General University Hospital of Patras, Patras, Greece
- Publication Type:Review Article
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2025;27(1):1-18
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Endovascular treatment of intracranial aneurysms (IAs) provides less invasiveness and lower morbidity than microsurgical clipping, albeit with a long-term recurrence rate estimated at 20%. We present our single-center experience and a literature review concerning surgical clipping of recurrent previously coiled aneurysms.
Methods:Retrospective analysis of nine (9) patients’ data and final clinical/angiographic outcomes, who underwent surgical clipping of IAs in our center following initial endovascular treatment, over a 12-year period (2010-2022). Regarding the literature review, data were extracted from 48 studies including 969 patients with 976 aneurysms.
Results:9 patients (5 males - 4 females) were included in the study with a mean age of 49 years. Subarachnoid hemorrhage was the initial presentation in 78% of patients. Aneurysms’ most common location was the middle cerebral artery bifurcation (5/9) followed by the anterior communicating artery (3/9) and the internal carotid artery bifurcation (1/9). Indications for surgery were coil loosening, coil compaction, sac regrowth, and residual neck. Procedure-related morbidity and mortality were zero whereas complete aneurysm occlusion was achieved after surgical clipping in all cases (100%). All patients had minimal symptoms or were asymptomatic (mRS 0-1) at the final follow-up.
Conclusions:Surgical clipping seems a feasible and safe technique for selected cases of recurrent previously coiled intracranial aneurysms. A universally accepted recurrence classification system and a guideline template for the management of such cases are needed.
