Summary of Relevant Clinical and Angiographic Data and Outcomes in 29 Patients with 31 Very Large or Giant Aneurysms

Patient No./Sex/Age (y)Clinical PresentationAneurysm Location and SizeTiming of Tx after SAHInitial OcclusionComplications of Initial CoilingOcclusion at First Follow-UpComplicationsAdditional Tx after CoilingOcclusion at Last Follow-Up*Final Occlusion†Clinical Result in Non-SAH PatientsGOS Score in SAH Patients
1/F/491) ME, ophthalmoplegia and 2) AA1) Carotid cavernous sinus, 35 mm, and 2) carotid ophthalmic, 20 mmNA1) Incomplete and 2) near completeNoneComplete at 5 moNoneNoneComplete at 15 moNAOphthalmoplegia improved at 64 moNA
2/M/46AA, SAHBasilar tip, 20 mmNACompleteNoneIncomplete at 10 moNoneRepeat coilingComplete at 16 moNAAsymptomatic at 55 moNA
3/F/35ME, decreased visual acuityCarotid bifurcation, 40 mmNAIncompleteNoneIncomplete at 3 moHemiparesisCarotid balloon occlusionIncomplete at 3 moComplete at 6 moDied of pneumonia after SAH from AA at 14 moNA
4/F/65SAH H&H IICarotid hypophyseal, 35 mm29 dCompleteNoneIncomplete at 11 moNoneRepeat coilingNear complete at 22 moNANA5 at 52 mo
5/M/48ME, mutism, hemiplegiaCarotid bifurcation, 55 mmNACompleteNoneIncomplete at 11 moNoneRepeat coiling, carotid balloon occlusionIncomplete at 11 moComplete at 21 moImproved at 51 moNA
6/M/52SAH H&H IIBasilar tip, 28 mm16 dIncompleteNoneIncomplete at 2 moBrainstem compression and edema, fatal rebleedBypass surgery to P2, bilateral vertebral occlusionIncomplete at 3 moIncomplete at 3 moNA1 at 6 mo, fatal rebleed
7/M/68SAH H&H IIBasilar tip, 26 mm15 dIncompleteNoneComplete at 3 moHydrocephalus, VP shuntNoneComplete at 3 moNANA5 at 49 mo
8/F/56ME, ataxia, facial palsyPICA, 32 mmNANear completeNoneIncomplete at 8 moNoneRepeat coilingComplete at 46 moNAAsymptomatic at 48 moNA
9/F/51ME, visual loss, ophthalmoplegiaCarotid ophthalmic, 35 mmNAIncompleteNoneIncomplete at 5 wkNoneBypass surgeryIncomplete at 5 wkCompleteUnchanged at 47 moNA
10/F/63SAH H&H IIBasilar tip, 21 mm33 dCompleteNoneComplete at 10 moNoneNoneComplete at 10 moNANA5 at 49 mo
11/M/40SAH H&H IIBasilar tip, 30 mm9 dCompleteNoneIncomplete at 10 moNoneRepeat coilingComplete at 33 moNANA5 at 45 mo
12/F/41SAH H&H IISupraclinoid carotid, 26 mm6 dNear completeNoneIncomplete at 6 wkNoneCarotid balloon occlusionIncomplete at 6 wkComplete at 7 moNA5 at 45 mo
13/M/57SAH H&H IIAcomA, 20 mm38 dIncompleteNoneIncomplete at 7 moNoneNoneIncomplete at 20 moNANA5 at 38 mo
14/F/50SAH H&H IIAcomA, 23 mm60 dCompleteNoneIncomplete at 6 moTransient hemiparesisRepeat coilingComplete at 21 moNANA5 at 33 mo
15/M/67ME, trigeminal neuralgiaSuperior cerebellar, 27 mmNACompleteNoneIncomplete at 6 moAneurysm dissection, bypass surgeryRepeat coiling, bypass surgeryIncomplete at 6 moComplete at 10 moImproved at 36 moNA
16/M/41SAH H&H IIAcomA, 20 mm22 dCompleteTE event in A2Near-complete at 6 moNoneNoneNear complete at 17 moNANA5 at 31 mo
17/M/61SAH H&H IIAcomA, 22 mm10 dNear completeNoneIncomplete (at 10 months)NoneRepeat coiling, clippingIncomplete at 10 moCompleteNA5 at 16 mo
18/F/55SAH H&H IIBasilar tip, 20 mm7 dCompleteNoneNear complete at 8 moNoneNoneNear complete at 22 moNANA5 at 22 mo
19/F/62SAH H&H IVPcomA, 20 mm4 dCompleteNoneIncomplete at 6 moNoneRepeat coilingNear complete at 12 moNANA3 at 14 mo
20/M/50SAH H&H IICarotid bifurcation, 20 mm8 dCompleteTE M1 occlusion, urokinase caused aneurysm rebleedNoneDeath due to TE event and rebleed due to urokinaseNoneNANANA1 at 1 d
21/M/36SAH H&H IAcomA, 24 mm21 dCompleteNoneIncomplete at 6 moNoneNoneIncomplete at 13 moNANA5 at 22 mo
22/M/61ME, frontal syndrome, mutismAcomA, 55 mmNACompleteTransient paresis, R legNoneNoneNoneNoneNADeath due to pneumonia at 3 moNA
23/M/52ME, frontal syndromeAcomA, 30 mmNAIncompleteNoneIncomplete at 6 moNoneNoneIncomplete at 13 moNAImproved at 13 moNA
24/F/47SAH H&H IIIBasilar tip, 20 mm2 dCompleteNoneComplete at 6 moNoneNoneComplete at 12 moNANA5 at 18 mo
25/F/43IncidentalBasilar tip, 26 mmNANear completeNoneIncomplete at 6 moNoneRepeat coilingNear complete at 15 moNAAsymptomatic at 15 moNA
26/F/511) SAH H&H I and 2) AA1) L carotid bifurcation, 25 mm; 2) carotid bifurcation R, 25 mm1) 18 d and 2) NANear completeNoneIncomplete at 6 mo1) None and 2) massive infarction resulting in death after bypass surgery1) recoiling and 2) clipping1) Near complete at 6 mo and 2) incomplete at 6 moNA1) None and 2) death due to surgical complication at 16 mo1 at 16 mo
27/F/54SAH H&H IIPcomA, 20 mm7 dCompleteNoneNear complete at 9 moNoneNoneNear complete at 40 moNANA5 at 40 mo
28/F/60SAH H&H IIBasilar trunk, 30 mm7 dNear completeNoneIncomplete at 7 moNone2× repeat coilingComplete at 17 moNANA5 at 17 mo
29/M/32SAH H&H ICarotid bifurcation, 20 mm7 dCompleteTransient hemiparesis, aphasiaComplete at 6 moNoneNoneComplete at 6 moNANA5 at 6 mo

  • Note.—AA indicates additional aneurysm; A2, second segment of the anterior cerebral artery; AcomA, anterior communicating artery; ME, mass effect; H&H, Hunt and Hess clinical grading at the time of treatment; NA, not applicable; PICA, posterior inferior cerebellar artery; TE, thromboembolic; Tx, treatment.

  • * After coiling or repeat coiling.

  • † After additional therapy other than coiling.