The Management of Residual and Recurrent Intracranial Aneurysms after Previous Endovascular or Surgical Treatment - A Report of Eighteen Cases

Abstract

We wish to report our experience in the management of residual or recurrent intracranial aneurysm after previous endovascular or surgical treatment. We performed a retrospective review of the clinical notes, operation records and cerebral angiograms of eighteen patients who were known to have undergone treatment for residual or recurrent aneurysms. During the period of April 1994 to May 1999, 210 patients were treated for an intracranial aneurysm either surgically or by endovascular methods. Eighteen of these patients (8.6%) were subsequently treated for residual or recurrent aneurysm. Thirteen achieved a complete occlusion. Complete occlusion was achieved in five of the eight patients who underwent endovascular treatment as a second procedure. Seven out of ten surgical cases achieved complete occlusion. Fifteen patients made a good recovery according to the Glasgow Outcome Score. Two patients who presented in a poor grade subarachnoid haemorrhage (SAH) were left severely disabled. One patient died after retreatment. The treatment of cerebral aneurysm remnants can be performed effectively using a variety of modalities. The original purpose of the treatment, which is total occlusion of the lesion, can thus be achieved.