[Difficulties in microsurgical treatment of aneurysms after coiling].
OBJECTIVE
The paper presents our own experience with microsurgical clipping of the cerebral aneurysms previously treated using endovascular techniques.


METHODS
The presented clinical material consists of 3 patients treated in such a way. A group of 60 patients was embolized. An initial satisfactory effect of endovascular treatment was verified within 12 months of observation. Control radiological examinations--plane skull x-ray and cerebral angiography (DSA)--revealed coil displacement and recanalization of the aneurysm. In each case a surgical clipping of the aneurysms was performed.


RESULTS
Proper clipping of previously coiled aneurysms sometimes presents a serious problem. Certain difficulties included rebuilding of the aneurysmal wall with a change of anatomical configuration in vessel ramifications.


CONCLUSIONS
Qualification for endovascular treatment and the existing risk of introduction of additional coils into the aneurysm sac was discussed in connection with our observations. Problems concerning surgical treatment of initially embolized cerebral aneurysms were discussed and illustrated. Radiological monitoring of patients after endovascular treatment was proposed.
Andrychowski
Jarosław
J
Klinika Neurochirurgii, Instytut Medycyny Doświadczalnej i Klinicznej, PAN w Warszawie, Szpital Bielański, ul. Cegłowska 80, 01-809 Warsaw, Poland. j.andrychowski@wp.pl
Czernicki
Zbigniew
Z
D000328:Adult; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D020099:Coated Materials, Biocompatible; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000601:surgery*; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible