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Management of complex, surgically intractable intracranial aneurysms: the option for intentional reconstruction of aneurysm neck followed by endovascular coiling
Authors:Chen Lukui  Kato Yoko  Sano Hirotoshi  Watanabe Sadayoshi  Yoneda Minoru  Hayakawa Motoharu  Sadato Akiyo  Irie Keiko  Negoro Makoto  Karagiozov Kostadin L  Kanno Tetsuo
Affiliation:Department of Neurosurgery, Fujita Health University, Toyoake, Japan. neuro_clk@hotmail.com
Abstract:
BACKGROUND: A limited series of patients with aneurysm were reviewed retrospectively to analyze strategies for integrating microsurgical and endovascular techniques in the management of complex, surgically intractable aneurysms. METHODS: Four patients were managed in Fujita Health University with a multimodality approach: intentional reconstruction of the aneurysm neck followed by endovascular coiling. RESULTS: A total of 5 aneurysms were treated, of which 3 were large or giant in size, and 3 were fusiform or multilobulated. Complete angiographic obliteration was confirmed in 4 aneurysms (80%). All patients had a good outcome (Glasgow Outcome Scale score 5; mean follow-up, 64 months). CONCLUSION: As for complex, surgically intractable aneurysms, the intentional reconstruction of the aneurysm neck followed by endovascular coiling should be considered more often.
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