ENDOVASCULAR TREATMENT OF BASILAR TIP ANEURYSMS USING ELECTROLYTICALLY DETACHABLE COILS

Preliminary experience using electrolytically detachable coils to trea t basilar tip aneurysms in 33 patients is described. The most frequent presentation was subarachnoid hemorrhage (SAH) in 23 patients. All pa tients were referred after neurosurgical assessment and exclusion as c andidates for surgical clipping of their aneurysms. At the time of ini tial treatment complete aneurysm occlusion was achieved in seven (21.2 %) of 33 patients. In 17 of the patients (51.5%), greater than 90% but less than 100% aneurysm occlusion was achieved. Angiographic follow u p (mean 11.7 months) was available in 19 patients. At follow-up angiog raphy four (21%) of 19 aneurysms were 100% occluded and 12 (63.2%) of 19 were more than 90% but less than 100% occluded. The mean clinical f ollow-up time in treated patients surviving beyond the initial treatme nt period is 15 months. One patient suffered major permanent morbidity from thrombosis of the basilar tip region a few hours after coil plac ement. One patient treated following SAH experienced further hemorrhag e 6 months later. No other patient suffered direct or indirect permane nt morbidity as a consequence of this method of treatment. The authors believe that this technique is a reasonable alternative for patients who are not candidates for conventional surgical treatment or in whom such treatment has failed. This study's follow-up period is brief and greater experience with long-term follow-up study is mandatory.