Management of complex, surgically intractable intracranial aneurysms: the option for intentional reconstruction of aneurysm neck followed by endovascular coiling.
BACKGROUND
A limited series of patients with aneurysm were reviewed retrospectively to analyze strategies for integrating microsurgical and endovascular techniques in the management of complex, surgically intractable aneurysms.


METHODS
Four patients were managed in Fujita Health University with a multimodality approach: intentional reconstruction of the aneurysm neck followed by endovascular coiling.


RESULTS
A total of 5 aneurysms were treated, of which 3 were large or giant in size, and 3 were fusiform or multilobulated. Complete angiographic obliteration was confirmed in 4 aneurysms (80%). All patients had a good outcome (Glasgow Outcome Scale score 5; mean follow-up, 64 months).


CONCLUSIONS
As for complex, surgically intractable aneurysms, the intentional reconstruction of the aneurysm neck followed by endovascular coiling should be considered more often.
Chen
Lukui
L
Department of Neurosurgery, Fujita Health University, Toyoake, Japan. neuro_clk@hotmail.com
Kato
Yoko
Y
Sano
Hirotoshi
H
Watanabe
Sadayoshi
S
Yoneda
Minoru
M
Hayakawa
Motoharu
M
Sadato
Akiyo
A
Irie
Keiko
K
Negoro
Makoto
M
Karagiozov
Kostadin L
KL
Kanno
Tetsuo
T
D000328:Adult; D001783:Blood Flow Velocity; D002533:Cerebral Angiography; D002548:Cerebral Revascularization / Q000295:instrumentation; D002560:Cerebrovascular Circulation; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013525:Surgical Instruments; D016896:Treatment Outcome; D014654:Vascular Patency