Article
Combined microsurgical and endovascular management of intracranial aneurysms as an interdisciplinary approach
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Published: | April 28, 2011 |
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Objective: To present the management of a series of patients who were treated with both clipping and coiling in a combined endovascular and microsurgical approach in a complementary way.
Methods: We analyzed 66 consecutive patients harboring 147 aneurysms from our intracranial aneurysm database admitted to our hospital from June 1999 to December 2009. Aneurysms were stratified according to (1) clipping in previously coiled residual or recurrent aneurysms (n=17), (2) coiling in previously clipped residual or recurrent aneurysms (n=10), and (3) multiple aneurysms with multimodality treatment (n=120). Outcome was assessed according to modified Rankin scale (mRs) at 6 months.
Results: Overall, 64 aneurysms (44%) were ruptured (WFNS 2 ± 1). Aneurysms that were treated in the groups 1 and 2 were larger in size compared to aneurysms in group 3 (8.4 mm vs. 5.4 mm; p=0.02). Complete aneurysm occlusion was achieved in 16 of 17 aneurysms (94.1%) in group 1, and in 8 of 10 patients (80%) of group 2. Overall favorable outcome (mRs 0-2) was achieved in 53 patients (80.3%).
Conclusions: Combined microsurgical clipping and endovascular coiling can be the treatment option of choice in selected cases; single complex aneurysms and multiple cerebral aneurysms.