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67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

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Surgical versus endovascular treatment of partially thrombosed intracranial aneurysm – single center series and systematic review

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  • Christian Wispel - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany
  • Patrick Schuss - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany
  • Alexis Hadjiathanasiou - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany
  • Valeri Borger - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany
  • Hartmut Vatter - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany
  • Erdem Güresir - Klinik und Poliklinik für Neurochirurgie, Universitätsklinikum Bonn, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.16.04

doi: 10.3205/16dgnc331, urn:nbn:de:0183-16dgnc3313

Published: June 8, 2016

© 2016 Wispel et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objective: Intracranial aneurysms are treated by surgical clipping or endovascular treatment. However, optimal therapeutic strategy concerning partially thrombosed intracranial aneurysms is still controversially discussed. Therefore, we analyzed surgical and endovascular results in patients with partially thrombosed intracranial aneurysms.

Method: Between 2006 and 2015, 16 consecutive patients with partially thrombosed intracranial aneurysms were treated at our institution. Aneurysm occlusion, aneurysm recurrence and retreatment was assessed and analyzed. Furthermore, MEDLINE was searched for published studies on treatment for partially thrombosed intracranial aneurysms to gain a larger population. Two reviewers independently extracted data.

Results: Of 16 patients treated at our institution, 11 underwent surgical clipping (69%) and 5 underwent endovascular treatment (31%). Literature data, including the present series revealed a total of 159 partially thrombosed intracranial aneurysms. Overall, 38% underwent surgical clipping, and 62% underwent endovascular treatment. Complete aneurysm occlusion was achieved in 92% of aneurysms treated surgically compared to 63% treated endovascularly (p<0.0001). Retreatment was necessary in no patient treated surgically versus 58% of patients treated endovascularly (p<0.0001).

Conclusions: The present data indicates that surgical clipping of partially thrombosed intracranial aneurysms leads to significantly higher complete occlusion rates and fewer necessity of retreatment. Nevertheless, for optimal treatment an interdisciplinary decision-making process is necessary in each individual case.