COIL PLACEMENT AFTER CLIPPING - ENDOVASCULAR TREATMENT OF INCOMPLETELY CLIPPED CEREBRAL ANEURYSMS - REPORT OF 2 CASES

In up to 4% of patients whose aneurysms are microsurgically clipped, t here is an expected or unexpected aneurysm residuum. The authors descr ibe two patients in whom surgical clipping did not result in complete obliteration of the aneurysm sac and in whom a second operation was no t believed to be the solution to the problem. In both patients complet e occlusion of the aneurysm residuum was achieved via an endovascular approach. Using the Guglielmi detachable coil system, it was possible to place two platinum coils selectively into the aneurysms. The endova scular approach may be a good treatment option for all patients in who m surgical clipping does not result in complete obliteration of the an eurysm sac and reoperation is contraindicated or unacceptable to the p atient.