INTRACRANIAL ANEURYSMS - ENDOVASCULAR TREATMENT WITH MECHANICAL DETACHABLE SPIRALS IN 60 ANEURYSMS

PURPOSE: To evaluate preliminary results with endovascular treatment ( EVT) of intracranial aneurysms with mechanical detachable spirals. MAT ERIALS AND METHODS: EVT with spirals was attempted in 57 patients with 60 aneurysms (47 berry, nine large, and four giant aneurysms). Thirty -seven patients had subarachnoid hemorrhage (three of whom were also t reated for associated aneurysm), nine were asymptomatic, six had heada che, three had mass effect, and two had neurologic deficits. RESULTS: EVT with the spirals was achieved in 55 (92%) of the 60 aneurysms. Of 42 treated berry aneurysms and 13 treated large and giant aneurysms, 3 3 berry and nine large and giant aneurysms underwent 3-month angiograp hic follow-up. Complete occlusion was attained in 23 berry and four la rge and giant aneurysms, subtotal occlusion (doubtful or obvious small neck remnant) was obtained in eight berry and four large and giant an eurysms, and incomplete occlusion was obtained in two berry aneurysms and one giant aneurysm. These results were obtained after one procedur e in 21 patients, after two procedures in 19 patients, and after three procedures in two patients. Seven patients had complications that nec essitated infusion of urokinase. Permanent neurologic deficits were fo und in three. There were no deaths. CONCLUSION: Good results were obta ined with EVT of intracranial aneurysms with mechanical detachable spi rals. These spirals are characterized by rapid detachment and low cost .