Stent/coil treatment of very large and giant unruptured ophthalmic and cavernous aneurysms

Erik Friedrich Hauck, Babu Guai Welch, Jonathan Ari White, Robert Edward Replogle, Phillip Douglas Purdy, Lee Glenn Pride, Duke Samson

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

Background: Treatment of VLGUIA remains a challenge. To reduce mass effect and achieve complete occlusion, open surgery has been our favored treatment. However, endovascular therapy is preferred for lesions in the cavernous sinus or for older patients with complicating medical problems. The goal of this study is to investigate outcome of stent and/or coil treatment of VLGUIA. Methods: Beginning in 2002, the neuroform stent has been available to the University of Texas Southwestern Medical Center in Dallas. Since then until 2006, 15 patients were treated for VLGUIA with stenting and/or coiling at this institution. These 15 patients were used for a retrospective analysis in this study. Results: Median patient age was 65 years, median aneurysm size was 27 mm (20-37 mm), and median follow-up time was 22 months. Eight aneurysms were localized in the cavernous sinus and 7 at the ophthalmic segment of the internal carotid artery. Four aneurysms were completely occluded (100%); 3 aneurysms, nearly complete (90%-99%); and 8 aneurysms, partial (<90% occlusion). Twelve patients required retreatment. Final GOS was 1 (good recovery) in 11 patients, 2 (moderate disability) in 3 patients, and 3 (severely disabled) in 1 patient. No patient died or deteriorated. Conclusions: Stent/coil management of VLGUIA is constantly evolving. Current treatment results are promising, with very low morbidity/mortality. Disadvantage is the frequent persistence of residual aneurysm.

Original languageEnglish (US)
Pages (from-to)19-24
Number of pages6
JournalSurgical neurology
Volume71
Issue number1
DOIs
StatePublished - Jan 1 2009

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Keywords

  • Cavernous aneurysm
  • Endovascular coil occlusion
  • Giant intracranial aneurysm
  • Ophthalmic aneurysm
  • Stent

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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