Aneurysm recurrence after treatment of paraclinoid/ophthalmic segment aneurysms--a treatment-modality assessment

Acta Neurochir (Wien). 2005 Jun;147(6):611-6; discussion 616. doi: 10.1007/s00701-005-0524-4.

Abstract

Object: The treatment of 21 paraclinoid/ophthalmic segment internal carotid artery aneurysms (PCOSAs) over a seven year period in a regional neurosurgical center was reviewed to assess the degree of obliteration and recurrence rate of these aneurysms after treatment by surgical and endovascular methods.

Method and result: An assessment of the clinical notes, operation records and cerebral angiograms was made to evaluate the rate of residual and recurrent aneurysms after treatment and at follow-up. In the coiling group, the aneurysm recurrence rate was eight out of fifteen aneurysms (53%). Four recurrences were from previously totally occluded aneurysms. Out of the six surgical cases, five had follow-up angiography performed. All had stable occlusions of their aneurysms including one with subtotal occlusion. Two clipping procedures after previous coiling achieved total occlusion of aneurysm on follow-up angiography.

Conclusion: Based on our case series we conclude that PCOSAs frequently recur after primary treatment. GDC coiling was associated with a higher rate of recurrent aneurysms when compared with surgical treatment. A review of the literature on the surgical and endovascular treatment of PCOSAs support this observation.

MeSH terms

  • Adult
  • Aged
  • Angioplasty*
  • Carotid Artery, Internal*
  • Embolization, Therapeutic*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Neurosurgical Procedures*
  • Ophthalmic Artery*
  • Recurrence
  • Retreatment
  • Retrospective Studies
  • Sella Turcica
  • Treatment Outcome