Treatment
of Giant Intracranial Aneurysms
X.
Lv,
C.
Jiang,
Y.
Li,
X.
Yang,
J.
Zhang,
Z.
Wu
Summary -
We
report
on
report
the
clinical
outcome
obtained
in
treatment
of
giant
intracranial
aneur-ysms
(GAs).
Between
2005
and
2007,
51
patients
with
51
GAs
presented
at
our
hospital.
Twenty-nine
were
treated
with
primary
parent
vessel
occlusion
without
distal
bypass
and
ten
underwent
treatment
preserving
the
parent
artery.
Twelve
patients
could
not
be
treated
endovascularly. Selective
embolization
(including
two
remodeling
techniques
and
two
stent-coil
embolizations)
resulted
in
only
one
cure.
Two
patients
died
as
a
result
of
subarachnoid
hemorrhage
periprocedurely.
Twenty-nine
patients
treated
primarily
with
parent
vessel
occlusion
and
three
patients
treated
with
covered
stent
were
considered
cured
after
their
treatments.
Only
one
patient
treated
with
parent
vessel
occlusion
experienced
ischemia
during
follow-up,
which
resulted
in
a
mild
neurological
deficit.
Of
the
twelve
patients
who
could
not
be
treated
endovascularly,
one
succumbed
to
surgery,
four
died
while
being
treated
conservatively,
and
three
were
lost
to
follow-up. Parent
artery
occlusion,
covered
stent
and
coil
occlusion
provide
effective
protection
against
bleeding.
In
treatment
of
paraclinoid
GAs
of
the
internal
carotid
artery,
the
use
of
a
stent,
and
stent-assisted
coil
embolization
may
be
a
pitfall.