BASILAR TIP ANEURYSM - ENDOVASCULAR TREATMENT WITH GUGLIELMI DETACHABLE COILS - MIDTERM RESULTS

PURPOSE: To determine the safety and effectiveness of Guglielmi detach able coils in the endovascular treatment of ruptured and nonruptured b asilar tip aneurysms. MATERIALS AND METHODS: A basilar tip aneurysm wa s occluded with Guglielmi detachable coils in 21 patients. The aneurys mal diameter was small (less than 12 mm) in 15 patients, large (12-25 mm) in four patients, and giant (more than 25 mm) in two patients. Ang iographic follow-up ranged from 6 to 48 months (mean, 26 months); clin ical follow-up ranged from 1 to 48 months. RESULTS: Embolization was t echnically successful in all patients. Complete occlusion was achieved in 14 (67%) patients; 90% occlusion was achieved in seven (33%) patie nts. There was partial reperfusion of the aneurysm in three patients ( 14%) after 6 months, which necessitated repeated embolization. The cli nical results were excellent in 13 patients, good in six, and fair in one. One patient died 2 months after the embolization due to pulmonary complications. A posterior cerebral artery was occluded in five (24%) patients; one of these patients developed a permanent neurologic defi cit, one developed a transient neurologic deficit, and three had no cl inical symptoms. CONCLUSION: Endovascular treatment of a basilar tip a neurysm with Guglielmi detachable coils seems to be a safe and less in vasive alternative to surgical clipping.