The retreatment: indications, technique and results.
Durability of endovascular treatment of intracranial aneurysms has always been an issue and a very strong point of criticism. Although studies on long-term results have made it clear that endovascular treatment safe and effective they, nonetheless showed retreatment after endovascular treatment is nearly 5-10 times more frequent than surgical clipping. Risk factors predisposing high probability of retreatment are aneurysm with dissecting nature, incomplete coiling, sac size larger than 10mm and localization at the bifurcations such as basilar tip. The indications for retreatment after endovascular treatment are not clear yet, although certain morphologic criteria can be used. Retreatment appears not to negate the initial advantage of endovascular treatment over surgical treatment and can be performed very small morbi-mortality numbers.
Istanbul University, Cerrahpasa Medical Faculty, Department of Radiology, Division of Neuroradiology, Kocamustafapasa, Istanbul 34098, Turkey. cislak@istanbul.edu.tr
Civan
C
Islak
D017542:Aneurysm, Ruptured / Q000517:prevention & control* / Q000628:therapy; D015984:Causality; D002548:Cerebral Revascularization / Q000706:statistics & numerical data*; D057510:Endovascular Procedures / Q000706:statistics & numerical data*; D019317:Evidence-Based Medicine; D006801:Humans; D002532:Intracranial Aneurysm / Q000453:epidemiology* / Q000628:therapy*; D015995:Prevalence; D012086:Reoperation; D012307:Risk Factors; D015996:Survival Rate; D017211:Treatment Failure
Angiography; Cerebral aneurysm; Cerebral vasculopathy; Endovascular treatment; Recurrence; Recurrent aneurysm; Retreatment