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Neurosurg Rev

Title:		Carotid artery occlusion for the treatment of symptomatic giant carotid aneurysms: a proposal of classification and surgical protocol
Author(s):		Rashad S; Hassan T; Aziz W; Marei A;
Address:		"Department of Neurosurgery, Alexandria University School of Medicine, Alexandria, Egypt"
Journal Title:		Neurosurg Rev
Year:		2014
Volume:		20140228
Issue:		3
Page Number:		501 - 511
DOI:		10.1007/s10143-014-0533-y
ISSN/ISBN:		1437-2320 (Electronic) 0344-5607 (Linking)
Abstract:		"Giant intracranial aneurysms are rare disorders that represent only 5% of all intracranial aneurysms; they have a wide variety of presentations including rupture, embolic effects, and mass effect symptoms that can mislead the diagnosis to tumors rather than aneurysms. Their treatment is difficult and carries higher morbidity and mortality than usual aneurysms due to their complex nature. This study involved retrospective analysis of data of 28 patients, managed between 2006 and 2012, suffering from giant internal carotid artery (ICA) aneurysms with various presenting symptoms, none of which was hemorrhage. They were all evaluated by BOT prior to any intervention; they were subjected to various treatment strategies including selective coiling, parent artery occlusion with or without bypass, aneurysm trapping with or without bypass, and patients were followed for a period ranging from 6 months to 5 years. Out of 26 patients with giant aneurysms with mass effects, 16 patients showed full recovery (61.5 %), 5 showed partial improvement (19.2 %), and 5 showed no change in mass effect symptoms (19.2 %). One patient died (3.5 %). Symptoms such as TIA or epistaxis showed complete recovery. This study shows that a well-designed protocol aiming at parent artery sacrifice will yield good to excellent results in managing ICA giant aneurysms, and it also shows that parent artery sacrifice is superior to other forms of treatment of these lesions regarding recurrence rates, morbidity, and mortality"
Keywords:		Adult Carotid Stenosis/*surgery Female Humans Intracranial Aneurysm/*surgery Male Middle Aged Postoperative Complications/prevention & control Recurrence Retrospective Studies Treatment Outcome *Vascular Surgical Procedures;
Notes:		"MedlineRashad, Sherif Hassan, Tamer Aziz, Waseem Marei, Ahmed eng Germany 2014/03/01 Neurosurg Rev. 2014 Jul; 37(3):501-11; discussion 511. doi: 10.1007/s10143-014-0533-y. Epub 2014 Feb 28"