Surgical Treatment for Ruptured Cerebral Aneurysm after Incomplete Coil Embolization

Abstract

We report on 4 patients surgically treated for ruptured aneurysm after incomplete coil embolization. Aneurysm was found in the anterior communicating artery in 3 patients and in the middle cerebral artery in 1. However, follow-up angiography revealed refilling of the aneurysm or enlargement of the residual neck. Prior to neck clipping, the coils were removed in 3 patients. Neck clipping was possible without coil removal in the remaining patient. There was no surgical morbidity and their final outcome was satisfactory. We discuss unique technical difficulties and pitfalls for neurosurgeons, and emphasize the possibility of the staged care strategy for poor-grade patients with subarachnoid hemorrhage