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62nd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Polish Society of Neurosurgeons (PNCH)

German Society of Neurosurgery (DGNC)

7 - 11 May 2011, Hamburg

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Combined microsurgical and endovascular management of intracranial aneurysms as an interdisciplinary approach

Meeting Abstract

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  • E. Güresir - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • P. Schuss - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • J. Platz - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • H. Vatter - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main
  • V. Seifert - Klinik für Neurochirurgie, Johann-Wolfgang-Goethe-Universität, Frankfurt am Main

Deutsche Gesellschaft für Neurochirurgie. Polnische Gesellschaft für Neurochirurgen. 62. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgen (PNCH). Hamburg, 07.-11.05.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. DocP 014

doi: 10.3205/11dgnc235, urn:nbn:de:0183-11dgnc2353

Published: April 28, 2011

© 2011 Güresir 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 the management of a series of patients who were treated with both clipping and coiling in a combined endovascular and microsurgical approach in a complementary way.

Methods: We analyzed 66 consecutive patients harboring 147 aneurysms from our intracranial aneurysm database admitted to our hospital from June 1999 to December 2009. Aneurysms were stratified according to (1) clipping in previously coiled residual or recurrent aneurysms (n=17), (2) coiling in previously clipped residual or recurrent aneurysms (n=10), and (3) multiple aneurysms with multimodality treatment (n=120). Outcome was assessed according to modified Rankin scale (mRs) at 6 months.

Results: Overall, 64 aneurysms (44%) were ruptured (WFNS 2 ± 1). Aneurysms that were treated in the groups 1 and 2 were larger in size compared to aneurysms in group 3 (8.4 mm vs. 5.4 mm; p=0.02). Complete aneurysm occlusion was achieved in 16 of 17 aneurysms (94.1%) in group 1, and in 8 of 10 patients (80%) of group 2. Overall favorable outcome (mRs 0-2) was achieved in 53 patients (80.3%).

Conclusions: Combined microsurgical clipping and endovascular coiling can be the treatment option of choice in selected cases; single complex aneurysms and multiple cerebral aneurysms.