Microsurgical Treatment of Previously Coiled Intracranial Aneurysms: Systematic Review of the Literature

World Neurosurgery
Omar M ArnaoutBernard R Bendok

Abstract

To assess indications, complications, clinical outcomes, and technical nuances of microsurgical treatment of previously coiled intracranial aneurysms. A systematic review of the literature was performed using PubMed/MEDLINE and EMBASE databases from January 1990 to December 2013. English-language articles reporting on microsurgical treatment of previously coiled intracranial aneurysms were included. Articles that involved embolization materials other than coils were excluded. Data on aneurysm characteristics, indications for surgery, techniques, complications, angiographic obliteration rates, and clinical outcomes were collected. The literature review identified 29 articles reporting on microsurgical clipping of 375 previously coiled aneurysms. Of the aneurysms, 68% were small (<10 mm). Indications for clipping included the presence of a neck remnant (48%) and new aneurysmal growth (45%). Rebleeding before clipping was reported in 6% of cases. Coil extraction was performed in 13% of cases. The median time from initial coiling to clipping was 7 months. The angiographic cure rate was 93%, with morbidity and mortality of 9.8% and 3.6%, respectively. Microsurgical clipping of previously coiled aneurysms can result in high obliterat...Continue Reading

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Citations

Feb 22, 2017·Surgical Neurology International·Giovanni GrassoR Loch Macdonald
Nov 18, 2018·Neurosurgery·Ivo S MuskensWouter A Moojen
May 16, 2019·Journal of Neurointerventional Surgery·Laurent PierotClaude Fabien Litre
Sep 25, 2020·Journal of Cerebrovascular and Endovascular Neurosurgery·Juwhan LeeYoung Gyun Jeong
Jan 7, 2020·Asian Journal of Neurosurgery·Raja K KuttyYoko Kato
Mar 17, 2017·Journal of Neurosurgery·M Yashar S KalaniRobert F Spetzler

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