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Summary of Relevant Clinical and Angiographic Data and Outcomes in 29 Patients with 31 Very Large or Giant Aneurysms
Patient No./Sex/Age (y) Clinical Presentation Aneurysm Location and Size Timing of Tx after SAH Initial Occlusion Complications of Initial Coiling Occlusion at First Follow-Up Complications Additional Tx after Coiling Occlusion at Last Follow-Up* Final Occlusion† Clinical Result in Non-SAH Patients GOS Score in SAH Patients 1/F/49 1) ME, ophthalmoplegia and 2) AA 1) Carotid cavernous sinus, 35 mm, and 2) carotid ophthalmic, 20 mm NA 1) Incomplete and 2) near complete None Complete at 5 mo None None Complete at 15 mo NA Ophthalmoplegia improved at 64 mo NA 2/M/46 AA, SAH Basilar tip, 20 mm NA Complete None Incomplete at 10 mo None Repeat coiling Complete at 16 mo NA Asymptomatic at 55 mo NA 3/F/35 ME, decreased visual acuity Carotid bifurcation, 40 mm NA Incomplete None Incomplete at 3 mo Hemiparesis Carotid balloon occlusion Incomplete at 3 mo Complete at 6 mo Died of pneumonia after SAH from AA at 14 mo NA 4/F/65 SAH H&H II Carotid hypophyseal, 35 mm 29 d Complete None Incomplete at 11 mo None Repeat coiling Near complete at 22 mo NA NA 5 at 52 mo 5/M/48 ME, mutism, hemiplegia Carotid bifurcation, 55 mm NA Complete None Incomplete at 11 mo None Repeat coiling, carotid balloon occlusion Incomplete at 11 mo Complete at 21 mo Improved at 51 mo NA 6/M/52 SAH H&H II Basilar tip, 28 mm 16 d Incomplete None Incomplete at 2 mo Brainstem compression and edema, fatal rebleed Bypass surgery to P2, bilateral vertebral occlusion Incomplete at 3 mo Incomplete at 3 mo NA 1 at 6 mo, fatal rebleed 7/M/68 SAH H&H II Basilar tip, 26 mm 15 d Incomplete None Complete at 3 mo Hydrocephalus, VP shunt None Complete at 3 mo NA NA 5 at 49 mo 8/F/56 ME, ataxia, facial palsy PICA, 32 mm NA Near complete None Incomplete at 8 mo None Repeat coiling Complete at 46 mo NA Asymptomatic at 48 mo NA 9/F/51 ME, visual loss, ophthalmoplegia Carotid ophthalmic, 35 mm NA Incomplete None Incomplete at 5 wk None Bypass surgery Incomplete at 5 wk Complete Unchanged at 47 mo NA 10/F/63 SAH H&H II Basilar tip, 21 mm 33 d Complete None Complete at 10 mo None None Complete at 10 mo NA NA 5 at 49 mo 11/M/40 SAH H&H II Basilar tip, 30 mm 9 d Complete None Incomplete at 10 mo None Repeat coiling Complete at 33 mo NA NA 5 at 45 mo 12/F/41 SAH H&H II Supraclinoid carotid, 26 mm 6 d Near complete None Incomplete at 6 wk None Carotid balloon occlusion Incomplete at 6 wk Complete at 7 mo NA 5 at 45 mo 13/M/57 SAH H&H II AcomA, 20 mm 38 d Incomplete None Incomplete at 7 mo None None Incomplete at 20 mo NA NA 5 at 38 mo 14/F/50 SAH H&H II AcomA, 23 mm 60 d Complete None Incomplete at 6 mo Transient hemiparesis Repeat coiling Complete at 21 mo NA NA 5 at 33 mo 15/M/67 ME, trigeminal neuralgia Superior cerebellar, 27 mm NA Complete None Incomplete at 6 mo Aneurysm dissection, bypass surgery Repeat coiling, bypass surgery Incomplete at 6 mo Complete at 10 mo Improved at 36 mo NA 16/M/41 SAH H&H II AcomA, 20 mm 22 d Complete TE event in A2 Near-complete at 6 mo None None Near complete at 17 mo NA NA 5 at 31 mo 17/M/61 SAH H&H II AcomA, 22 mm 10 d Near complete None Incomplete (at 10 months) None Repeat coiling, clipping Incomplete at 10 mo Complete NA 5 at 16 mo 18/F/55 SAH H&H II Basilar tip, 20 mm 7 d Complete None Near complete at 8 mo None None Near complete at 22 mo NA NA 5 at 22 mo 19/F/62 SAH H&H IV PcomA, 20 mm 4 d Complete None Incomplete at 6 mo None Repeat coiling Near complete at 12 mo NA NA 3 at 14 mo 20/M/50 SAH H&H II Carotid bifurcation, 20 mm 8 d Complete TE M1 occlusion, urokinase caused aneurysm rebleed None Death due to TE event and rebleed due to urokinase None NA NA NA 1 at 1 d 21/M/36 SAH H&H I AcomA, 24 mm 21 d Complete None Incomplete at 6 mo None None Incomplete at 13 mo NA NA 5 at 22 mo 22/M/61 ME, frontal syndrome, mutism AcomA, 55 mm NA Complete Transient paresis, R leg None None None None NA Death due to pneumonia at 3 mo NA 23/M/52 ME, frontal syndrome AcomA, 30 mm NA Incomplete None Incomplete at 6 mo None None Incomplete at 13 mo NA Improved at 13 mo NA 24/F/47 SAH H&H III Basilar tip, 20 mm 2 d Complete None Complete at 6 mo None None Complete at 12 mo NA NA 5 at 18 mo 25/F/43 Incidental Basilar tip, 26 mm NA Near complete None Incomplete at 6 mo None Repeat coiling Near complete at 15 mo NA Asymptomatic at 15 mo NA 26/F/51 1) SAH H&H I and 2) AA 1) L carotid bifurcation, 25 mm; 2) carotid bifurcation R, 25 mm 1) 18 d and 2) NA Near complete None Incomplete at 6 mo 1) None and 2) massive infarction resulting in death after bypass surgery 1) recoiling and 2) clipping 1) Near complete at 6 mo and 2) incomplete at 6 mo NA 1) None and 2) death due to surgical complication at 16 mo 1 at 16 mo 27/F/54 SAH H&H II PcomA, 20 mm 7 d Complete None Near complete at 9 mo None None Near complete at 40 mo NA NA 5 at 40 mo 28/F/60 SAH H&H II Basilar trunk, 30 mm 7 d Near complete None Incomplete at 7 mo None 2× repeat coiling Complete at 17 mo NA NA 5 at 17 mo 29/M/32 SAH H&H I Carotid bifurcation, 20 mm 7 d Complete Transient hemiparesis, aphasia Complete at 6 mo None None Complete at 6 mo NA NA 5 at 6 mo Note.—AA indicates additional aneurysm; A2, second segment of the anterior cerebral artery; AcomA, anterior communicating artery; ME, mass effect; H&H, Hunt and Hess clinical grading at the time of treatment; NA, not applicable; PICA, posterior inferior cerebellar artery; TE, thromboembolic; Tx, treatment.
* After coiling or repeat coiling.
† After additional therapy other than coiling.
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