Aneurysm recurrence after treatment of paraclinoid/ophthalmic segment aneurysms--a treatment-modality assessment.
OBJECTIVE
The treatment of 21 paraclinoid/ophthalmic segment internal carotid artery aneurysms (PCOSAs) over a seven year period in a regional neurosurgical center was reviewed to assess the degree of obliteration and recurrence rate of these aneurysms after treatment by surgical and endovascular methods.


RESULTS
An assessment of the clinical notes, operation records and cerebral angiograms was made to evaluate the rate of residual and recurrent aneurysms after treatment and at follow-up. In the coiling group, the aneurysm recurrence rate was eight out of fifteen aneurysms (53%). Four recurrences were from previously totally occluded aneurysms. Out of the six surgical cases, five had follow-up angiography performed. All had stable occlusions of their aneurysms including one with subtotal occlusion. Two clipping procedures after previous coiling achieved total occlusion of aneurysm on follow-up angiography.


CONCLUSIONS
Based on our case series we conclude that PCOSAs frequently recur after primary treatment. GDC coiling was associated with a higher rate of recurrent aneurysms when compared with surgical treatment. A review of the literature on the surgical and endovascular treatment of PCOSAs support this observation.
Boet
R
R
Division of Neurosurgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
Wong
G K C
GK
Poon
W S
WS
Lam
J M K
JM
Yu
S C H
SC
D000328:Adult; D000368:Aged; D017130:Angioplasty; D002343:Carotid Artery, Internal; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D009880:Ophthalmic Artery; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D012658:Sella Turcica; D016896:Treatment Outcome