title: Parent artery occlusion is not obsolete in giant aneurysms of the ICA. Experience with very-long-term follow-up.
abstract: BACKGROUND
  The purpose of this study was to present the long-term clinical and angiographic follow-up (FU) in 26 consecutive patients with giant/large aneurysms (G/LAs) of the internal carotid artery (ICA) treated by parent artery occlusion (PAO).
  
  
  METHODS
  Twenty-two of 26 G/LAs of the ICA were treated by PAO when a balloon test occlusion prior to occlusion of the ICA was tolerated. Clinical and angiographic FU were available in, respectively, 20 and 18 patients with a mean delay of 6.1 years (range 1.5-11).
  
  
  RESULTS
  At long-term FU, clinical symptoms had disappeared in 75% of the patients, partially regressed in 10%, and remained unchanged in 15% of cases. No patient presented worsening of clinical symptoms or intracranial bleeding. Fifteen patients presented a modified Rankin scale score of 0 and five patients a score of 1. On imaging FU, persistent occlusion of the PA was observed in 17/18 cases. One case of aneurysmal recanalization was observed at long-term FU. PAO was well tolerated in all patients. On angiographic FU, no new lesion was detected, except the growing of a pre-existing aneurysm located on the carotid siphon contralateral to the occluded vessel.
  
  
  CONCLUSIONS
  Our study demonstrates that occlusion of the parent artery for giant/large ICA aneurysms remains a safe and effective technique with good clinical and angiographic outcome at long-term FU.
authors.affiliation: Department of Neuroradiology, Pitié-Salpêtrière Hospital, APHP, Paris VI University, 47 Bd de l'Hôpital, 75013, Paris, France. fredclare5@msn.com
authors.forename: Frédéric
authors.initials: F
authors.lastname: Clarençon
authors.forename: Fabrice
authors.initials: F
authors.lastname: Bonneville
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Boch
authors.forename: Lise
authors.initials: L
authors.lastname: Lejean
authors.forename: Alessandra
authors.initials: A
authors.lastname: Biondi
mesh_terms: D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000628:therapy*; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015641:Radiography, Interventional / Q000379:methods*; D060205:Therapeutic Occlusion / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult