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Clipping of Recurrent Cerebral Aneurysms After Coil Embolization

  • Shingo Toyota
  • Tetsuya Kumagai
  • Tetsu Goto
  • Kanji Mori
  • Takuyu Taki
Conference paper
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 129)

Abstract

Background and aims. To assess the technical points of surgical clipping for recurrent aneurysms after coiling, we examine a consecutive series of 14 patients who underwent re-treatment.

Materials and methods. From 2009 to 2016, 27 recurrent aneurysms after coiling were re-treated with endovascular treatment or surgical clipping. Of these, 14 were re-treated surgically. In cases where the remnant neck was sufficiently large, neck clipping was chosen. Where the remnant neck was too small and the border between the thrombosed and non-thrombosed portion was distinct, partial clipping was chosen. Surgical clipping was attempted without removing the coils when technically feasible.

Results. Among the 14 cases, neck clipping was performed in 11, partial clipping in 2, and trapping with bypass in 1 case. Clipping without removal of coils was accomplished in all cases. No neurological deterioration occurred after surgical clipping in any case.

Conclusion. Clipping of recurrent aneurysms after coiling can compensate for the failure of initial endovascular therapy. For clipping without removal of coils, precise evaluation of the remnant neck is required. Bypass surgery is key to treatment in the case of aneurysm trapping.

Keywords

Cerebral aneurysm Clipping Coil embolization Recurrence Retreatment 

Notes

Conflict of Interests Disclosure

Nothing to report.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Shingo Toyota
    • 1
  • Tetsuya Kumagai
    • 1
  • Tetsu Goto
    • 1
  • Kanji Mori
    • 1
  • Takuyu Taki
    • 1
  1. 1.Department of NeurosurgeryKansai Rosai HospitalAmagasakiJapan

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