title: Regrowth of aneurysm sacs from residual neck following aneurysm clipping.
abstract: It is recognized that incomplete treatment of an aneurysm may result in recurrent hemorrhage with serious or fatal consequences. For this reason, patients treated at the authors' institution in whom a large portion of the aneurysm neck or sac remained after application of a clip or ligature have been subjected to reoperation. However, 1- to 2-mm residual necks seen in postoperative angiography have been thought to pose little risk. Some cases of aneurysms recurring from a narrow residual neck after clipping have been reported, and a few instances of recurrent aneurysm have been described after apparently complete occlusion of the neck (as observed angiographically or in the surgeon's judgment). In recent years, a surprising number of cases have been presented in which this seemingly unimportant remnant of the neck dilated over a long period to become a dangerous aneurysm. This finding stresses the importance of complete aneurysm occlusion and of postoperative angiography for the recognition of a residual aneurysm neck. This should be important not only in aneurysm clipping but also in the endovascular treatment of intracranial aneurysms with detachable balloons.
authors.affiliation: Department of Diagnostic Radiology (Neuroradiology), University Hospital, University of Western Ontario, London, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Lin
authors.forename: A J
authors.initials: AJ
authors.lastname: Fox
authors.forename: C G
authors.initials: CG
authors.lastname: Drake
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D014057:Tomography, X-Ray Computed