INTRACRANIAL BERRY ANEURYSMS - ANGIOGRAPHIC AND CLINICAL-RESULTS AFTER ENDOVASCULAR TREATMENT

PURPOSE: To determine the types of aneurysm that may be treated endova scularly with platinum detachable coils. MATERIALS AND METHODS: Two hu ndred eight patients with 236 intracranial berry aneurysms underwent e ndovascular coil embolization; 150 patients had subarachnoid hemorrhag e at the time of presentation. RESULTS: Treatment was performed in 182 patients with 203 (86%) aneurysms (86%). Follow-up angiograms were ob tained at 3 months in 160 cases of aneurysm. A second procedure was pe rformed in 18 (11%) of these cases, and a third was performed in one c ase. Final follow-up results in 152 aneurysms demonstrated total occlu sion in 123 (81%) cases, subtotal occlusion in 26 (17%) cases, and inc omplete occlusion in three (2%) cases. All patients with subtotally oc cluded aneurysm were scheduled for later angiographic follow-up and an y indicated repeat treatment. Technique-related morbidity rate was 4% (seven patients with permanent neurologic deficits due to clotting). T echnique-related mortality rate was 2% (perioperative rupture in two, hematoma due to urokinase perfusion in one, rebleeding of the initial hematoma after excessive uncontrolled anticoagulation in one). Rebleed ing occurred in one patient after incomplete occlusion. CONCLUSION:: E ndovascular coil embolization seems to be a reliable technique, with g ood anatomic and clinical results, that provides protection against re bleeding of ruptured aneurysms.