Coil Embolization in Patients with Recurrent Cerebral Aneurysms Who Previously Underwent Surgical Clipping

Kim, S.-T.; Baek, Jin Wook; Jin, Sung-Chul; Park, Joon Ha; Kim, J.S.; Kim, H.Y.; Jeong, Hae Woong

doi:10.3174/ajnr.a5909

Cited by 6 publications

(2 citation statements)

References 16 publications

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“…Multiple studies have described coiling after clipping of cerebral aneurysms, 14 but coiling across the clipped segment has not been previously described. We propose naturally occurring intracranial anastomotic channels, namely, ACom A. and PCom A. as reasonably efficacious routes to access "difficult-to-access" lesions requiring some skills.…”

Section: Discussionmentioning

confidence: 99%

Endovascular coiling of recurrent trapped pseudoaneurysm of petrous ICA across the distal barrier: When the other way round is the only way around!

et al. 2022

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Background The pseudoaneurysms of the internal carotid artery (ICA) at the skull base form a unique subset of craniofacial pseudoaneurysms with varied diagnostic and therapeutic challenges. Recurrence in a surgically treated pseudoaneurysm may become a nightmare due to very limited number of open and endovascular options. Report We report a rare case of recurrent pseudoaneurysm of petrous ICA, which presented with massive epistaxis following an initial successful occlusion by surgical trapping of the parent arterial segment with surgical clip. Cerebral angiography revealed filling of the pseudoaneurysm by small arterial channels from the external carotid, contralateral internal carotid and basilar arterial branches and emptying through the “slipped” distal clip. After a meticulous analysis of the cerebral angiogram, the recurrent pseudoaneurysm was eventually embolized retrogradely through the “slipped” clip after crossing the anterior communicating artery taking a contralateral internal carotid access. Conclusion Scrupulous planning and execution of ICA pseudoaneurysms is necessary to prevent recurrence. Naturally occuring collateral routes through the Circle of Willis aid in treatment of “unreachable” vascular lesions.

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Section: Discussionmentioning

confidence: 99%

Endovascular coiling of recurrent trapped pseudoaneurysm of petrous ICA across the distal barrier: When the other way round is the only way around!

et al. 2022

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“…There are already some reports about changing treatment modality, like changing from microsurgery to coil embolization, changing from coil embolization to microsurgery, or applying hybrid treatment. 2 ) 9 ) 14 ) 20 ) Among them, microsurgical treatment, such as aneurysm neck clipping or trapping with or without bypass, could be an effective and safe approach when retreatment of a recurred aneurysm that was previously treated by endovascular treatment seems difficult. However, because microsurgical treatment policies for cerebral aneurysm vary between hospitals it is unclear how effective this strategy may be.…”

Section: Introductionmentioning

confidence: 99%

Microsurgical treatment for the recurrent cerebral aneurysm initially treated using coil embolization

Lee

Kim

Shim

et al. 2020

J Cerebrovasc Endovasc Neurosurg

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Objective: Microsurgical treatment could be a good alternative for the treatment of recurrent cerebral aneurysm after coil embolization. The purpose of this study was to present our experience of microsurgical treatment for recurrent cerebral aneurysm previously treated using coil embolization. Methods: From June 2012 to May 2019, 34 patients consecutively received microsurgical treatment for a recurrent cerebral aneurysm previously treated using coil embolization after it ruptured. Results: Of the 34 patients with aneurysm, 33 had the aneurysm located in the anterior circulation. The most common location was the anterior communicating artery (13 cases). Immediate radiologic outcome at coil embolization was completed (n=6), residual neck (n=26), and residual sac (n=2). The reason for microsurgical treatment included rebleeding (n=12), persistent residual sac (n=1), and recurrence on follow-up study (n=21). Rebleeding occurred within 10 days after coil embolization in 10 cases, and the other 2 were due to regrowth. In the 20 recurred and saccular aneurysms, coil compaction was present in 11 aneurysms and regrowth in 9 aneurysms. Simple neck clipping (n=29) and clipping with coil mass extraction (n=3) was possible in the saccular aneurysms. The blood blister like aneurysm (n=2) were treated using bypass and endovascular internal carotid artery trapping. In the follow-up study group after microsurgical treatment there were no severe complications due to the treatment. Age, cause of retreatment, and modified Rankin Scale before microsurgery were associated with good outcome (p<0.001). Conclusions: Microsurgical treatment may be a viable and effective option for treating recurrent aneurysms previously treated by endovascular techniques.

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Comparison of Subtracted Computed Tomography from Computed Tomography Perfusion and Digital Subtraction Angiography in Residue Evaluation of Treated Intracranial Aneurysms

et al. 2019

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Coil Embolization in Patients with Recurrent Cerebral Aneurysms Who Previously Underwent Surgical Clipping

Cited by 6 publications

References 16 publications

Endovascular coiling of recurrent trapped pseudoaneurysm of petrous ICA across the distal barrier: When the other way round is the only way around!

Endovascular coiling of recurrent trapped pseudoaneurysm of petrous ICA across the distal barrier: When the other way round is the only way around!

Microsurgical treatment for the recurrent cerebral aneurysm initially treated using coil embolization

Comparison of Subtracted Computed Tomography from Computed Tomography Perfusion and Digital Subtraction Angiography in Residue Evaluation of Treated Intracranial Aneurysms

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