Introduction and Purpose Because postoperative adhesion and re-craniotomy have been limitations of surgical revision in the residual aneurysms after clipping, so coil embolization has been used as an alternative technique for surgical clipping in the residual aneurysm after clipping. In this study, we investigated the clinical and radiological results of patients treated with coil embolization for residual aneurysms after surgical clipping retrospectively.

Materials and Methods Between 1999 and 2018, 19 aneurysms of 19 patients who underwent coil embolization for residual aneurysms observed after clipping or wrapping were studied.

Results Eight patients presented with subarachnoid hemorrhage at the time of clipping (42.1%). The median interval between surgical clipping and coil embolization was 21 days (range, 0–2595 days). Techniques of coil embolization included single catheter (n=15), stent assisted (n=3), and stent deployment only without coiling (n=1). Immediate radiologic findings after coil embolization showed complete occlusion in 5 patients, a residual neck in 10 patients, and a residual sac in 4 patients. There was no procedural morbidity and mortality. Intraprocedural rupture was occurred in one case, but there was no neurological deficits after procedure. All patients of residual aneurysm after surgical clipping treated by coil embolization were available for clinical follow-up. The mean clinical follow-up was 33.4±24.7 months. Poor clinical outcomes (modified Rankin Scale score ≥ 3) at the end of the clinical follow-up were reported in 4 patients (21%). However, all four patients had the same clinical results as before the coil embolization. Angiographic follow-up was available for 14 patients (73.7%). Minor recanalization was detected in only 1 patient, but no need to re-treatment (7.1%).

Conclusions According to our study, coil embolization for residual aneurysm after surgical clipping may probably be a feasible, safe, and relative durable treatment modality.

Disclosures J. Baek: None. H. Jeong: None.