Objective: To report our experiences in the treatment of recurrent intracranial aneurysms with re-coiling or covered stents.
Methods: A total of 291 patients with 305 intracranial aneurysms were treated with detachable coils, and 41 (28.9%) of 142 patients with aneurysms in the internal carotid artery (ICA) had a recurrent aneurysm during the follow-up period. For this study, 31 recurrent aneurysms in 31 patients who had angiograms within six months following retreatment with detachable coils (group A, n = 20) or covered stents (group B, n =11) were analyzed. Aneurysms were categorized as complete or incomplete occlusion via angiographic assessment and graded as full recovery, improvement, no change, or deterioration via clinical assessment. Data regarding technical success, initial and final angiographic results, mortality, morbidity, and final clinical outcome were collected and analyzed postoperatively.
Results: Coil embolization and covered stent placement were technically successful in all recurrent aneurysms. The initial angiographic results showed complete occlusion in 11 patients (55%) in group A and 8 (72.7%) in group B (P= 0.452), and the final angiographic results exhibited complete occlusion in 10 patients (50%) in group A and 11 (100 %) in group B (P= 0.005). There were no significant differences in technique success, mortality, culminate morbidity, or final clinical outcome between the two groups.
Conclusions: Recurrent aneurysms after coiling can be successfully treated and occluded with re-coiling or covered stent placement. However, covered stents seem to be more effective than re-coiling with regard to complete occlusion of recurrent aneurysms.
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