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59th Annual Meeting of the German Society of Neurosurgery (DGNC)
3rd Joint Meeting with the Italian Neurosurgical Society (SINch)

German Society of Neurosurgery (DGNC)

1 - 4 June 2008, Würzburg

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Combined treatment of intracranial aneurysms by endovascular coiling and microsurgical clipping as an interdisciplinary approach

Kombinierte Behandlung intrakranieller Aneurysmen mittels Coiling und Clipping

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  • corresponding author A. Jaiimsin - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • E. Güresir - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • J. Beck - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • A. Raabe - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Klinikum der Johann-Wolfgang-Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. Società Italiana di Neurochirurgia. 59. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3. Joint Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch). Würzburg, 01.-04.06.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocSO.04.02

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2008/08dgnc025.shtml

Published: May 30, 2008

© 2008 Jaiimsin et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: To present a consecutive series of patients treated with both clipping and coiling in a complementary combined endovascular and microsurgical approach.

Methods: We analyzed 36 consecutive patients with 50 aneurysms, who were treated by clipping and coiling in a total of 3 specific groups: clipping after attempted or incomplete coiling (5 anerysms, 10%), coiling after attempted or incomplete clipping (4 aneurysms, 8%) and multiple aneurysms treated with both clipping and coiling (41 aneurysms, 82%) according to our intracranial aneurysms database from 1999 to 2007.

Results: 34 patients (95%) first presented with SAH, mean WFNS1. The anatomic distribution in a total 50 aneurysms was as follows: 40 aneurysms (80%) in the anterior circulation, 10 aneurysms (20%) in the posterior circulation. Mean aneurysm size was 6.2mm. All aneurysms of the first 2 groups were regarded as complex. The mean age were 46.78 years. Complete aneurysm occlusion was achieved in 90% (aneurysm). 77,5% achieved a favourable outcome (mRs 0-2), 22,5% a poor outcome. 2 patients died: 1 patient rebled and died after intended incomplete aneurysm occlusion, another due to severe cerebral vasospasm.

Conclusions: Especially for complex intracranial aneurysms or patients with multiple cerebral aneurysms, the interdisciplinary conference between experienced neurosurgeons and interventional neuroradiologists in a neurovascular center is mandatory for the best results. Combined microsurgical clipping and endovascular coiling can be the treatment option of choice in selected patients.