Management of Residual and Recurrent Aneurysms After Clipping or Coiling: Clinical Characteristics, Treatments, and Follow-Up Outcomes

Endovascular management of recurrent anterior communicating aneurysm previously embolized. Case presentation

“…Dorfer and all showed that 15,2% of the aneurysm smaller than 10mm and 38,2% of the aneurysm larger than 10mm had relevant recurrences and similarly 17,2% of aneurysm with neck <4mm and 27,3% with neck >4mm presented with recurrences. They also reported that a threshold of 25% packing density and 30% volumetric aneurysm filling has been correlated with significantly stable angiographic results [2,5,6].…”

“…The reported rebleed rate after endovascular therapy indicated in ISAT1 was 0.2% per patient year with a follow-up from 1 to 8 years (mean, 4 years) and 1.3/100 patient years in the CARAT study, with no haemorrhage occurred after 2 years[..]. The main factors to be considered when deciding on the method of treatment used in the aneurysmal recurrence were represented by the aneurysm size and location, patient age and clinical condition, size of aneurysm remnant and its relation with adjacent vessels, presence of coils in the aneurysm neck, mechanism of recurrence and history of SAH manifestation [2,6].…”

Residual lesions in patients undergoing microsurgical clipping of cerebral aneurysms in a reference university hospital

“…More recently, with the increasing use of endovascular techniques, postoperative control has become obligatory in all techniques ( 9 , 12 ). In this regard, the International Subarachnoid Aneurysm Trial ( 13 ) showed residual lesion rates of up to 26% in aneurysms treated using the endovascular approach and approximately 12% in cases managed with microsurgery ( 1 , 13 ). However, the rate of aneurysm occlusion after rebleeding was not considered.…”

“…Major advances in the diagnosis and management of cerebral aneurysms have been made in the past 30 years ( 1 ). Generally, the ultimate goal of aneurysm treatment is to achieve complete occlusion while avoiding rupture or rebleeding ( 2 ) and preserving the patency of adjacent arteries.…”

“…Generally, the ultimate goal of aneurysm treatment is to achieve complete occlusion while avoiding rupture or rebleeding ( 2 ) and preserving the patency of adjacent arteries. This treatment can be performed using microsurgical techniques or the endovascular approach ( 1 - 3 ).…”