title: Endovascular management of giant aneurysms: An introspection.
abstract: OBJECTIVE
  To evaluate the outcome of giant intra-dural aneurysms managed with endovascular techniques.
  
  
  METHODS
  We retrospectively reviewed a series of 39 consecutive giant intra-dural aneurysms. The technical feasibility of endovascular treatment, its complications, the angiographic results and the clinical outcome were assessed. Logistic regression analysis was performed to evaluate for predictors of a poor outcome.
  
  
  RESULTS
  Nine patients were left untreated. During a 30 month follow-up, four of them (44.4%) died and two (22.2%) deteriorated. Thirty aneurysms (12 located in the anterior circulation and 18 located in the posterior circulation) were treated using endovascular methods. Of these, 11 were treated by parent vessel occlusion, 11 by stent-assisted coiling, one using only coils, six using solely a stent, and, one using both coils and onyx. During a 28 month follow-up, seven (23.3%) patients died and two (6.7%) patients experienced permanent neurological deficits. The mortality and morbidity in the endovascular group seemed lower than that in the untreated group (P = 0.045, 30% vs. 66.7%). There was no difference in the results of endovascular treatment between giant intra-dural aneurysms located in the posterior and the anterior circulation.
  
  
  CONCLUSIONS
  Giant intra-dural aneurysms, whether treated or not, may have a poor clinical outcome. The outcome following endovascular treatment of these lesions is better than its natural history when left untreated. However, endovascular treatment may often be associated with high complication rates and a low chance of cure.
authors.forename: Zhenhai
authors.initials: Z
authors.lastname: Zhang
authors.forename: Xianli
authors.initials: X
authors.lastname: Lv
authors.forename: Xinjian
authors.initials: X
authors.lastname: Yang
authors.forename: M U
authors.initials: MU
authors.lastname: Shiqing
authors.affiliation: Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, People,s Republic of China.
authors.forename: Zhongxue
authors.initials: Z
authors.lastname: Wu
authors.forename: Chunsen
authors.initials: C
authors.lastname: Shen
authors.forename: Ruxiang
authors.initials: R
authors.lastname: Xu