Endovascular treatment of partially clipped aneurysms

Partial clipping may occur in about 4% of surgical procedures. The risk of hemorrhage persists if the aneurysm in not completely excluded. Reoperation s are often difficult, technically demanding and may carry an increased ris k of complications. We report our experience with the use of Guglielmi deta chable coils in the treatment of 9 aneurysm remnants. Five patients (55.6%) presented with a second subarachnoid hemorrhage. Eight of the aneurysms (8 8.9%) were located on the anterior circulation. Postoperative angiography s howed complete occlusion in 8 cases (88.9%). Certain partial clipping types may assist and favor a stable coiling procedure allowing a more compact ca st. On the other hand, the clip may interfere with the correct visualizatio n of the neck. In this series, there was no neurological morbidity associat ed with the procedure. There were no hemorrhagic events during or after the embolization. Endovascular treatment of aneurysm remnants can be performed safely and may constitute a valuable option to microsurgery.