Surgical management of recurrent aneurysms after coiling treatment.
OBJECTIVE
Aneurysms that recur after coiling treatment are difficult to manage. The microsurgical technique in these cases differs significantly from that in regular aneurysm clipping. We present our experience in surgical management of aneurysms that recurred more than 1 month after coiling in a series of 19 patients.


METHODS
Between January 2004 and December 2014, 1437 patients were treated surgically for intracranial aneurysms in our institution. We performed a retrospective review of the clinical records, operation videos, and cerebral angiograms. We focused on patients in whom the initial aneurysm was treated by coiling, but the results were incomplete or the aneurysm recurred.


RESULTS
Nineteen patients underwent surgical clipping for recurrent aneurysm more than 1 month after initial coiling treatment. The sex ratio (male:female) was 0.9, and the average age was 51.3 years (range 35-72 years). One aneurysm was classified as giant (≥ 25 mm), two as large (10-25 mm), and 18 as small (≤ 10 mm). A good outcome (Glasgow Outcome Scale 4 or 5) was observed in 16 of 19 patients (84.2%).


CONCLUSIONS
Microsurgical clipping can be safe and effective in the management of previously coiled residual and recurrent aneurysms.
a Department of Neurosurgery , Chinese PLA General Hospital , Beijing , PR China.
Hua-Wei
HW
Wang
a Department of Neurosurgery , Chinese PLA General Hospital , Beijing , PR China.
Zheng-Hui
ZH
Sun
a Department of Neurosurgery , Chinese PLA General Hospital , Beijing , PR China.
Chen
C
Wu
a Department of Neurosurgery , Chinese PLA General Hospital , Beijing , PR China.
Zhe
Z
Xue
a Department of Neurosurgery , Chinese PLA General Hospital , Beijing , PR China.
Xin-Guang
XG
Yu
D000328:Adult; D000368:Aged; D001807:Blood Vessel Prosthesis; D002533:Cerebral Angiography; D002548:Cerebral Revascularization; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Intracranial aneurysm; coiling; microsurgical clipping; recurrent aneurysm