[Endovascular treatment of intracranial aneurysms. Value and prospects based on a series of 92 cases].

Overview

Endovascular treatment of intracranial aneurysms is a recent technique which needs to be evaluated in large series. From 1978 to 1988, 92 cases of aneurysms were balloon-treated at Lariboisière Hospital either by parent vessel occlusion (O.V.P.) (N = 48) or by selective obliteration (O.S.A.). Treatment in all but 5 cases was performed 3 weeks after S.A.H. since the main reason for choosing endovascular technique was contraindication of early surgery. Giant aneurysms account for 31 cases, vertebro-basilar for 38 and cavernous carotid for 27. In O.V.P. group, there were 17 patients referred after subarachnoid hemorrhage and 30 after tumoral symptoms, while in O.S.A. group, 30 bled and 5 presented with oculomotor palsies. Results in the O.V.P. group are good with 8% morbidity and mortality. In O.S.A., they are worse: 16% (morbidity and mortality) and 22% of secondary balloon deflation; however, because of the features of these aneurysms (size and location), the results seem quite acceptable. Endovascular treatment of intracranial aneurysms is a promising technique which should already replace parent vessel ligation when indicated, and progressively supplant surgical clipping when the remaining technical problems are resolved.