The interdisciplinary treatment of unruptured intracranial aneurysms.
BACKGROUND
The purpose of this article is to present the results of microsurgical clipping or endovascular coil obliteration of unruptured intracranial aneurysms (UIA), in a single cerebrovascular center with regard to successful obliteration and periprocedural complications.


METHODS
Data concerning patients with UIA were recorded in the neurovascular database of the neurosurgical department at the University of Frankfurt. The outcome of treatment was assessed with the modified Rankin Scale.


RESULTS
126 patients were treated by open surgery and 74 patients by endovascular coil obliteration. After treatment, the rate of new, mostly transient neurological deficits was 5%, and there were no deaths related to any treatment in this series. The outcome was good in 124 (98.4%) of the surgically treated patients and 73 (98.6%) of the endovascularly treated patients, and only 3 patients (1.5%) had a treatment-related unfavorable outcome. 98% of the treated aneurysms were satisfactorily obliterated. Seven endovascularly treated patients required retreatment because of coil compaction leading to recanalization of the aneurysm.


CONCLUSIONS
The majority of patients with unruptured intracranial aneurysms, even complex ones, can be treated by microsurgery or endovascular aneurysm obliteration with very good clinical results and a very low percentage of unfavorable outcomes. With careful patient selection and individualized assignment of the best form of treatment to each patient, we were able to achieve a low overall complication rate and a very high rate of obliteration in our specialized neurovascular center.
Seifert
Volker
V
Klinik für Neurochirurgie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main, Schleusenweg 2-16, Frankfurt/Main, Germany.
Gerlach
Rüdiger
R
Raabe
Andreas
A
Güresir
Erdem
E
Beck
Jürgen
J
Szelényi
Andrea
A
Setzer
Matthias
M
Vatter
Hartmut
H
Du Mesnil de Rochemont
Richard
R
Zanella
Friedhelm
F
Sitzer
Matthias
M
Berkefeld
Joachim
J