Skip to main content
Log in

Individual Management of Recurrent Intracranial Aneurysms: The Wuxi Experience

  • Original Paper
  • Published:
Cell Biochemistry and Biophysics Aims and scope Submit manuscript

Abstract

Recurrent intracranial aneurysms can occur after either surgical clipping or endovascular therapy. In this article, we present a consecutive series of 18 patients who underwent individual treatment for recurrent aneurysms after primary coil embolization or surgical clipping. During an 8-year period between May 1997 and December 2005, 18 patients underwent individual treatment for recurrent aneurysms. Clinical data and imaging studies of the patients were analyzed retrospectively. Out of the 18 patients, 13 had recurrent aneurysms located in the anterior circulation, and 5 had aneurysms of the posterior circulation. Treatment consisted of coiling in 16 patients and clipping in two patients. Of the 18 patients, 15 achieved a good or excellent recovery, two were paralyzed, and one died post-treatment. Both the surgical clipping and endovascular embolization for the treatment of recurrent intracranial aneurysms can achieve very good radiological results with low mortality rates. One of the key points for the successful treatment of this kind of lesions is the proper, individual, and interdisciplinary patient selection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Byrne, J. V., Sohn, M. J., Molyneux, A. J., & Chir, B. (1999). Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. Journal of Neurosurgery, 90, 656–663.

    Article  PubMed  CAS  Google Scholar 

  2. Vinuela, F., Duckwiler, G., & Mawad, M. (1997). Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients. Journal of Neurosurgery, 86, 475–482.

    Article  PubMed  CAS  Google Scholar 

  3. Murayama, Y., Nien, Y. L., Duckwiler, G., Gobin, Y. P., Jahan, R., Frazee, J., et al. (2003). Guglielmi detachable coil embolization of cerebral aneurysms: 11 years’ experience. Journal of Neurosurgery, 98, 959–966.

    Article  PubMed  Google Scholar 

  4. Raymond, J., Guilbert, F., Weill, A., Georganos, S. A., Juravsky, L., Lambert, A., et al. (2003). Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke, 34, 1398–1403.

    Article  PubMed  Google Scholar 

  5. Brach, R. F. (2009). Coil or clip? Current trends in the treatment of intracranial aneurysms. JAAPA Journal of American Academy of Physician Assistants, 22(37–38), 32–40.

    Google Scholar 

  6. Byrne, J. V. (2006). The aneurysm “clip or coil” debate. Acta Neurochirurgica (Wien), 148, 115–120.

    Article  CAS  Google Scholar 

  7. Drake, C. G., & Allcock, J. M. (1973). Postoperative angiography and the “slipped” clip. Journal of Neurosurgery, 39, 683–689.

    Article  PubMed  CAS  Google Scholar 

  8. Drake, C. G., Friedman, A. H., & Peerless, S. J. (1984). Failed aneurysm surgery. Reoperation in 115 cases. Journal of Neurosurgery, 61, 848–856.

    Article  PubMed  CAS  Google Scholar 

  9. Feuerberg, I., Lindquist, C., Lindqvist, M., & Steiner, L. (1987). Natural history of postoperative aneurysm rests. Journal of Neurosurgery, 66, 30–34.

    Article  PubMed  CAS  Google Scholar 

  10. Macdonald, R. L., Wallace, M. C., & Kestle, J. R. (1993). Role of angiography following aneurysm surgery. Journal of Neurosurgery, 79, 826–832.

    Article  PubMed  CAS  Google Scholar 

  11. Paterson, A. (1968). Direct surgery in the treatment of posterior communicating aneurysms. Lancet, 2, 808–811.

    Article  PubMed  CAS  Google Scholar 

  12. Lin, T., Fox, A. J., & Drake, C. G. (1989). Regrowth of aneurysm sacs from residual neck following aneurysm clipping. Journal of Neurosurgery, 70, 556–560.

    Article  PubMed  CAS  Google Scholar 

  13. Ng, P., Khangure, M. S., Phatouros, C. C., Bynevelt, M., ApSimon, H., & McAuliffe, W. (2002). Endovascular treatment of intracranial aneurysms with Guglielmi detachable coils: analysis of midterm angiographic and clinical outcomes. Stroke, 33, 210–217.

    Article  PubMed  CAS  Google Scholar 

  14. Molyneux, A. J., Kerr, R. S., Yu, L. M., Clarke, M., Sneade, M., Yarnold, J. A., et al. (2005). International subarachnoid aneurysm trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet, 366, 809–817.

    Article  PubMed  Google Scholar 

  15. Batjer, H. H., & Samson, D. S. (1992). Reoperation for aneurysms and vascular malformations. Clinical Neurosurgery, 39, 140–171.

    PubMed  CAS  Google Scholar 

  16. Giannotta, S. L., & Litofsky, N. S. (1995). Reoperative management of intracranial aneurysms. Journal of Neurosurgery, 83, 387–393.

    Article  PubMed  CAS  Google Scholar 

  17. Nakase, H., Kamada, Y., Aoki, H., Goda, K., Morimoto, T., & Sakaki, T. (2000). Clinical study on recurrent intracranial aneurysms. Cerebrovascular Diseases, 10, 255–260.

    Article  PubMed  CAS  Google Scholar 

  18. Asgari, S., Wanke, I., Schoch, B., & Stolke, D. (2003). Recurrent hemorrhage after initially complete occlusion of intracranial aneurysms. Neurosurgical Review, 26, 269–274.

    PubMed  Google Scholar 

  19. Gurian, J. H., Martin, N. A., King, W. A., Duckwiler, G. R., Guglielmi, G., & Vinuela, F. (1995). Neurosurgical management of cerebral aneurysms following unsuccessful or incomplete endovascular embolization. Journal of Neurosurgery, 83, 843–853.

    Article  PubMed  CAS  Google Scholar 

  20. Hodgson, T. J., Carroll, T., & Jellinek, D. A. (1998). Subarachnoid hemorrhage due to late recurrence of a previously unruptured aneurysm after complete endovascular occlusion. AJNR American Journal of Neuroradiology, 19, 1939–1941.

    PubMed  CAS  Google Scholar 

  21. Makoui, A. S., Smith, D. A., Evans, A. J., & Cahill, D. W. (2000). Early aneurysm recurrence after technically satisfactory Guglielmi detachable coil therapy: is early surveillance needed? Case report. Journal of Neurosurgery, 92, 355–358.

    Article  PubMed  CAS  Google Scholar 

  22. Manabe, H., Fujita, S., Hatayama, T., Suzuki, S., & Yagihashi, S. (1998). Rerupture of coil-embolized aneurysm during long-term observation. Case report. Journal of Neurosurgery, 88, 1096–1098.

    Article  PubMed  CAS  Google Scholar 

  23. Kang, H. S., Han, M. H., Kwon, B. J., Kwon, O. K., & Kim, S. H. (2006). Repeat endovascular treatment in post-embolization recurrent intracranial aneurysms. Neurosurgery, 58, 60–70. discussion 60–70.

    Article  PubMed  Google Scholar 

  24. Cekirge, H. S., Islak, C., Firat, M. M., Kocer, N., & Saatci, I. (2000). Endovascular coil embolization of residual or recurrent aneurysms after surgical clipping. Acta Radiologica, 41, 111–115.

    Article  PubMed  CAS  Google Scholar 

  25. Hoh, B. L., Carter, B. S., Putman, C. M., & Ogilvy, C. S. (2003). Important factors for a combined neurovascular team to consider in selecting a treatment modality for patients with previously clipped residual and recurrent intracranial aneurysms. Neurosurgery, 52, 732–738. discussion 738–739.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lin Yu-chang.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yu-chang, L., Kesari, S., Bing, L. et al. Individual Management of Recurrent Intracranial Aneurysms: The Wuxi Experience. Cell Biochem Biophys 61, 349–354 (2011). https://doi.org/10.1007/s12013-011-9217-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12013-011-9217-1

Keywords

Navigation