title: Treatment of giant/large internal carotid aneurysms: parent artery occlusion or stent-assisted coiling.
abstract: OBJECTIVE
  Treatment of giant/large internal carotid aneurysm is a challenge for neurologists. Previously, parent artery occlusion was the classic therapy; now the stent-assisted coil embolization has become available in recent years, but the optimal therapy is under debate. The goal of the present study was to compare two endovascular treatment modalities in terms of safety, efficacy and short-term outcomes.
  
  
  METHODS
  All the patients were divided into two groups: Group A: patients who underwent parent artery occlusion, and Group B: patients who underwent stent-assisted coil embolization. Follow-up outcomes were evaluated using the modified Rankin Scale (mRS).
  
  
  RESULTS
  After 12 months of follow-up, the favorable outcome (mRS: 0-2) had no statistical significance in both groups (p = 1.00). Patients in group A had greater ischemia compared with patients in group B, but the difference did not reach statistical significance (p = 0.421). In group B, patients had a higher rate of partial occlusion (p = 0.255) and recurrence (10% vs. 0%; p = 0.586).
  
  
  CONCLUSIONS
  Stent-assisted coiling may not be superior to parent artery occlusion in selected patients after short-term follow-up. Parent artery occlusion is a simple, safe and effective treatment for large/giant internal carotid aneurysms.
authors.affiliation: a Department of Neurosurgery, Neurosurgery Institute, Key Laboratory on Brain Function, Repair and Regeneration of Guangdong, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Li
authors.affiliation: a Department of Neurosurgery, Neurosurgery Institute, Key Laboratory on Brain Function, Repair and Regeneration of Guangdong, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xu-Ying
authors.initials: XY
authors.lastname: He
authors.affiliation: a Department of Neurosurgery, Neurosurgery Institute, Key Laboratory on Brain Function, Repair and Regeneration of Guangdong, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xi-Feng
authors.initials: XF
authors.lastname: Li
authors.affiliation: a Department of Neurosurgery, Neurosurgery Institute, Key Laboratory on Brain Function, Repair and Regeneration of Guangdong, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: a Department of Neurosurgery, Neurosurgery Institute, Key Laboratory on Brain Function, Repair and Regeneration of Guangdong, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Yan-Chao
authors.initials: YC
authors.lastname: Liu
authors.affiliation: a Department of Neurosurgery, Neurosurgery Institute, Key Laboratory on Brain Function, Repair and Regeneration of Guangdong, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Chuan-Zhi
authors.initials: CZ
authors.lastname: Duan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000628:therapy; D021721:Balloon Occlusion; D001925:Brain Damage, Chronic / Q000209:etiology; D002343:Carotid Artery, Internal; D002533:Cerebral Angiography; D002648:Child; D003389:Cranial Nerve Diseases / Q000209:etiology; D004621:Embolization, Therapeutic / Q000295:instrumentation / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015607:Stents; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D016896:Treatment Outcome
keywords: giant aneurysm; internal carotid aneurysm; parent artery occlusion; stent-assisted coiling