Endovascular Coil Embolization After Clipping: Endovascular Treatment of Incompletely Clipped or Recurred Cerebral Aneurysms

Abstract

Objective : The presence of a cerebral aneurysm remnant after surgicalclipping is associated with a risk of regrowth or rupture. For these recurredaneurysms, coil embolization can be considered as a treatmentoption. We retrospectively reviewed cases of ruptured or regrown aneurysmsafter clipping treated by endovascular coil embolization. Materials and Methods : We conducted a retrospective review of patientswith ruptured or recurred aneurysm after clipping, who underwent coilembolization between January 1995 and December 2013. We evaluatedclinical information and the outcomes of these cases. Results : Eight patients were treated by endovascular coil embolization aftersurgical clipping. Six aneurysms were located in the anterior communicatingartery, one in the posterior communicating artery, and one in themiddle cerebral artery bifurcation. All patients were initially treated by surgicalclipping because of a ruptured aneurysm. Aneurysm recurrence atthe initial clipping site was detected in all cases. The median intervalfrom initial to second presentation was 42 months. In four patients,aneurysms were detected before rupture and the four remaining patientspresented with recurrent subarachnoid hemorrhage. All patients weretreated by coil embolization and showed successful occlusion of aneurysmswithout complications. Conclusion : Endovascular coil embolization can be a safe and successfultreatment option for recurred aneurysms after clipping.