title: [Indications and surgical treatments for failed coiled aneurysms].
abstract: The possibility of treating intra-cranial aneurysms (ICA) through an endovascular approach is a great progress. But, as any technique, it has its own limitations. Multidisciplinary neurovascular teams are regularly confronted with ICA where embolization is a poor option or even failed (a residue of more than 5% at six months follow-up or after recanalization). Another potential failure is a coil extrusion into the parent vessel with thrombo-embolic risks. Our team and others in the world developed strategies to manage these complex cases. After a brief review of the literature, we describe our experience and present a modified Gurian classification. This classification allows a better identification of the various failed coiled aneurysms types and their potential surgical treatments.
authors.affiliation: Département de neurochirurgie, cliniques universitaires Saint-Luc, université catholique de Louvain, 10, avenue Hippocrate, 1200 Bruxelles, Belgique.
authors.forename: G
authors.initials: G
authors.lastname: Vaz
authors.forename: M-A
authors.initials: MA
authors.lastname: Docquier
authors.forename: P
authors.initials: P
authors.lastname: Goffette
authors.forename: C
authors.initials: C
authors.lastname: Raftopoulos
mesh_terms: D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008866:Microsurgery / Q000379:methods*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods*