Results after surgical and endovascular treatment of paraclinoid aneurysms by a combined neurovascular team.

摘要: OBJECTIVE: Advances in surgical and endovascular techniques have improved treatment for paraclinoid aneurysms. A combined team can formulate individualized strategies patients with Patients who are considered to be at high risk treated endovascularly minimize morbidity. We reviewed the clinical radiographic outcomes of 238 aneurysms by our unit. METHODS: From 1991 1999, neurovascular 216 Massachusetts General Hospital. The modality each aneurysm was chosen based on anatomic factors, offered higher risks. One hundred eighty were direct surgery, 57 occlusion, one extracranial-intracranial bypass internal carotid artery balloon occlusion. Locations transitional, 12 (5%); cave, 11 ophthalmic, 131 (55%); posterior wall, 38 (16%); superior hypophyseal 46 (19%). Lesions contained completely within cavernous sinus excluded from this analysis. RESULTS: Using Glasgow Outcome Scale (GOS), overall excellent or good (GOS 5 4), 86%; fair 3), 7%; poor 2), 4%; death 1), 3%. Among surgically patients, 90% experienced 6% had 2% 3% died 1). 74% 12% 10% 4% major minor complication rate surgery 29%, a surgery-related permanent morbidity mortality 0%. 21%, endovascular-related rate. Visual presented visual symptoms as follows: improved, 69%; no change, 25%; worsened, 6%; new deficits, In general, angiographic efficacy lower group. CONCLUSION: approach coiling lead aneurysms, including high-risk lesions that might not been previous series.