The management of residual and recurrent intracranial aneurysms after previous endovascular or surgical treatment--a report of eighteen cases

Abstract

Object: We wish to report our experience in the management of residual or recurrent intracranial aneurysm after previous endovascular or surgical treatment.

Methods: We performed a retrospective review of the clinical notes, operation records and cerebral angiograms of eighteen patients who were known to have undergone treatment for residual or recurrent aneurysms.

Results: During the period of April 1994 to May 1999, 210 patients were treated for an intracranial aneurysm either surgically or by endovascular methods. Eighteen of these patients (8.6%) were subsequently treated for residual or recurrent aneurysm. Thirteen achieved a complete occlusion. Complete occlusion was achieved in five of the eight patients who underwent endovascular treatment as a second procedure. Seven out of ten surgical cases achieved complete occlusion. Fifteen patients made a good recovery according to the Glasgow Outcome Score. Two patients who presented in a poor grade subarachnoid haemorrhage (SAH) were left severely disabled. One patient died after retreatment.

Conclusions: The treatment of cerebral aneurysm remnants can be performed effectively using a variety of modalities. The original purpose of the treatment, which is total occlusion of the lesion, can thus be achieved.