Abstract
Objective: Preliminary results using mechanically detachable coils (MDC) to treat basilar top aneurysms are reported.
Material: The subjects were 3 females and 2 males. The most frequent presentation was subarachnoid hemorrhage in 4 patients. All patients were referred to us after neurosurgical assessment and their exclusion as candidates for aneurysm neck clipping procedures.
Intervention: All treatments were performed using MDC under intubated general anesthesia.
Measurement and Results: In the initial treatment, complete aneurysm occlusion was achieved in 2 patients, 85% occlusion in 2, and 90% occlusion in 1. Asymptomatic cerebral infarction caused by coil migration in the parent artery was recognized in 2 patients. The mean clinical follow-up period was 10.8 months. Regrowth of the remnant space which had escaped endovascular treatment was found 10 month after the initial treatment in 1 case. In this particular case, secondary treatment was undertaken endovascularly. The clinical-outcome of all 5 patients was excellent (100% in Karnofsky Performance Status).
Conclusion: Clinically, the endovascular treatment of basilar top aneurysms revealed some disadvantages with the coils which indicated that further adjustments of mechanically detachable coils are necessary to improve treatment results. We consider this technique to be a reasonable alternative for patients who are not candidates for conventional surgical treatment, or for whom such treatment has failed. The follow-up period in this series was rather short, and further study with long-term follow-up is needed.
