Abstract

Background: To retrospectively evaluate the clinical and angiographic outcome in patients with giant intracranial aneurysms, who had been primarily treated with detachable coils.
Material/Methods: A group of 23 patients with saccular intracranial giant aneurysms, who were treated with endovascular embolization, was analyzed. Evaluation included clinical presentation, technical success rate, complications, early clinical outcome, and results of early (6 months) angiographic follow-up.
Results: Embolization was feasible in all cases. Immediate total occlusion of the aneurysm was achieved in 9 patients, subtotal in 7, and incomplete in 7. Among the 23 treated patients, 9 showed improvement of clinical symptoms, 8 remained stable, 4 worsened, and 2 died. No rebleeding was noted either during the hospitalization period or after discharge. After 6 months, recanalization of a different grade was noted in 10 patients, and in 6 patients additional embolization was necessary. Recanalization was more common with the use of two-dimensional coils only (57%) than with the use of two-dimensional and three-dimensional coils (50%) or with stent assistance (0%).
Conclusions: Despite the low periprocedural risk for the patient, embolization with detachable coils only is not encouraging owing to frequent recanalization, and may be considered as an alternative to surgery only in carefully selected patients, and with stent assistance.

Keywords: giant intracranial aneurysm , transarterial embolization , Guglielmi detachable coil , intracranial stent, intracranial aneurysm