title: Endovascular management of giant middle cerebral artery aneurysms.
abstract: BACKGROUND
  This article reported the experience of endovascular treatment in giant middle cerebral artery (MCA) aneurysms with parent artery occlusion or stent-assisted coiling.
  
  
  METHODS
  Eleven consecutive patients with giant MCA aneurysms were included. The aneurysms predominantly involved the M1 segment in two cases, bifurcation in four cases, and M2 in five cases. Four M2 fusiform aneurysms were treated with parent artery sacrifice after balloon occlusion test. The seven unruptured aneurysms and one ruptured one were treated with stent-assisted coiling. The post-operation and long-term follow-up angiographic and clinical outcomes were analyzed.
  
  
  RESULTS
  Endovascular coiling was performed successfully in all 11 cases. All four M2 fusiform cases using parent artery occlusion strategy achieved complete occlusion of aneurysms. In the seven cases with stent-assisted coiling, four were completely occluded, two were partially occluded and one remained small residue. Mild perioperative complications occurred in six patients. The follow-up angiography taken at a mean of 13.5 months of eight patients showed that seven aneurysms remained stable or improved and one M1 aneurysms relapsed and needed further treatment.
  
  
  CONCLUSIONS
  Stent-assisted coiling or parent artery occlusion of selected giant MCA aneurysms is an option to consider.
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University Shanghai 200040, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University Shanghai 200040, China.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Cao
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University Shanghai 200040, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Ge
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University Shanghai 200040, China.
authors.forename: Gang
authors.initials: G
authors.lastname: Lu
authors.affiliation: Department of Radiology, Jing'an District Central Hospital of Huashan Hospital Jing'an Branch, Fudan University Shanghai 200040, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wan
authors.affiliation: Department of Radiology, Jing'an District Central Hospital of Huashan Hospital Jing'an Branch, Fudan University Shanghai 200040, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Jing'an District Central Hospital of Huashan Hospital Jing'an Branch, Fudan University Shanghai 200040, China.
authors.forename: Weijin
authors.initials: W
authors.lastname: Gu
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University Shanghai 200040, China.
authors.forename: Xiaolong
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Huashan Hospital, Fudan University Shanghai 200040, China.
authors.forename: Daoying
authors.initials: D
authors.lastname: Geng
keywords: Aneurysm; endovascular treatments; giant; middle cerebral artery