Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by van Rooij, W.J. Articles by Sluzewski, M. Search for Related Content PubMed PubMed Citation Articles by van Rooij, W.J. Articles by Sluzewski, M.

American Journal of Neuroradiology 28:1405-1408, August 2007
DOI 10.3174/ajnr.A0556
© 2007 American Society of Neuroradiology

INTERVENTIONAL

Coiling of Very Large and Giant Basilar Tip Aneurysms: Midterm Clinical and Angiographic Results

W.J. van Rooij^a and M. Sluzewski^a

^a From the Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands

Please address correspondence to W.J. van Rooij MD, PhD, Department of Radiology, St. Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, 5022 GC Tilburg, The Netherlands; e-mail: radiol{at}knmg.nl

BACKGROUND AND PURPOSE: The purpose of this study was to report the midterm clinical and angiographic results of coiling of very large (>15 mm) and giant basilar tip aneurysms.

MATERIALS AND METHODS: Between January 1995 and October 2005, 44 very large and giant basilar tip aneurysms in 44 patients were coiled. There were 13 men (30%) and 31 women (70%) with a mean age of 51.4 years (median, 51 years; range, 34–72 years). Mean aneurysm size was 19.6 mm (range, 15–30 mm). Of 44 aneurysms, 33 (75%) had ruptured. Of 11 unruptured basilar tip aneurysms, 7 were incidentally discovered, 1 was additional to another ruptured aneurysm, and 3 were symptomatic by mass effect.

RESULTS: Procedural mortality was 2/44 (4.6%, 95% confidence interval (CI), 0.4%–16%) and morbidity 1/44 (2.3%, 95% CI, 0.01%–13%). Of 33 patients with ruptured aneurysms, mean clinical follow-up was 5.2 years (range, 0.5–11.5 years). Two patients had a rebleeding from the coiled basilar tip aneurysm leading to death in 1 patient and to dependency in the other patient (annual rebleeding rate, 1.1%) One other patient died 2 years later of progressive brain stem compression. Mean angiographic follow-up in 41 of 42 surviving patients was 3.1 years. Nineteen aneurysms reopened and were coiled for a second time. Of these, 9 repeatedly reopened with time and were repeatedly coiled up to 6 times. Additional treatments were without complications.

CONCLUSION: Coiling of very large and giant basilar tip aneurysms is associated with reasonably low morbidity. Although additional treatment during follow-up is frequently necessary, rebleeding is uncommon.

This article has been cited by other articles:

				W.J. van Rooij and M. Sluzewski Endovascular Treatment of Large and Giant Aneurysms AJNR Am. J. Neuroradiol., January 1, 2009; 30(1): 12 - 18. [Abstract] [Full Text] [PDF]

				W.J. van Rooij and M. Sluzewski Unruptured Large and Giant Carotid Artery Aneurysms Presenting with Cranial Nerve Palsy: Comparison of Clinical Recovery after Selective Aneurysm Coiling and Therapeutic Carotid Artery Occlusion AJNR Am. J. Neuroradiol., May 1, 2008; 29(5): 997 - 1002. [Abstract] [Full Text] [PDF]