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Microsurgical Management of Recurrent Intracranial Aneurysms Following Endovascular Treatment: a Single Institution Illustrative Case Series and Literature Review
Acta clinica Croatica, 60 (2021), 4; 695-702. https://doi.org/10.20471/acc.2021.60.04.17
Rotim, Krešimir; Kalousek, Vladimir; Vrban, Filip; Splavski, Bruno

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Rotim, K., Kalousek, V., Vrban, F. i Splavski, B. (2021). Microsurgical Management of Recurrent Intracranial Aneurysms Following Endovascular Treatment: a Single Institution Illustrative Case Series and Literature Review. Acta clinica Croatica, 60. (4), 695-702. doi: 10.20471/acc.2021.60.04.17

Rotim, Krešimir, et al. "Microsurgical Management of Recurrent Intracranial Aneurysms Following Endovascular Treatment: a Single Institution Illustrative Case Series and Literature Review." Acta clinica Croatica, vol. 60, br. 4, 2021, str. 695-702. https://doi.org/10.20471/acc.2021.60.04.17

Rotim, Krešimir, Vladimir Kalousek, Filip Vrban i Bruno Splavski. "Microsurgical Management of Recurrent Intracranial Aneurysms Following Endovascular Treatment: a Single Institution Illustrative Case Series and Literature Review." Acta clinica Croatica 60, br. 4 (2021): 695-702. https://doi.org/10.20471/acc.2021.60.04.17

Rotim, K., et al. (2021) 'Microsurgical Management of Recurrent Intracranial Aneurysms Following Endovascular Treatment: a Single Institution Illustrative Case Series and Literature Review', Acta clinica Croatica, 60(4), str. 695-702. doi: 10.20471/acc.2021.60.04.17

Rotim K, Kalousek V, Vrban F, Splavski B. Microsurgical Management of Recurrent Intracranial Aneurysms Following Endovascular Treatment: a Single Institution Illustrative Case Series and Literature Review. Acta clinica Croatica [Internet]. 2021. [pristupljeno 08.12.2024.];60(4):695-702. doi: 10.20471/acc.2021.60.04.17

K. Rotim, V. Kalousek, F. Vrban i B. Splavski, "Microsurgical Management of Recurrent Intracranial Aneurysms Following Endovascular Treatment: a Single Institution Illustrative Case Series and Literature Review", Acta clinica Croatica, vol. 60, br. 4, str. 695-702, 2021. [Online]. Dostupno na: https://urn.nsk.hr/urn:nbn:hr:220:777011. [Citirano: 08.12.2024.]

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Naslov (engleski)Microsurgical Management of Recurrent Intracranial Aneurysms Following Endovascular Treatment: a Single Institution Illustrative Case Series and Literature Review
Naslov (hrvatski)Mikrokirurško liječenje recidivirajućih intrakranijskih aneurizma nastalih nakon endovaskulanih postupaka: ilustrativni prikaz serije bolesnika i pregled literature
AutorKrešimir Rotim
AutorVladimir Kalousek
AutorFilip Vrban
AutorBruno Splavski https://orcid.org/0000-0002-4483-9364
Autorova ustanova(Klinički bolnički centar Sestre milosrdnice)
Znanstveno / umjetničko
područje, polje i grana		BIOMEDICINA I ZDRAVSTVO
Kliničke medicinske znanosti
Neurologija
Sažetak (engleski)
Microsurgical clipping and endovascular coiling are both effective management modalities for intracranial aneurysms, whereas recent procedures are mainly directed towards endovascular treatment because of its minimally invasive nature. However, such a treatment has been associated with a bigger risk of recurrent aneurysmal growth and re-bleeding urging a selection of optimal strategies to overcome these hazards. It seems that the most appropriate method of choice is microsurgical clipping, which is much more technically challenging due to recurrent aneurysm demanding configuration created by the initial coiling. Herein, we present an illustrative institutional case series of recurrent intracranial aneurysms following endovascular treatment, and discuss the controversies and benefits of their subsequent microsurgical management, based on our experience and on literature review. Considering the results reported in this paper, it seems that careful selective microsurgical neck clipping with/without aneurysmal sac resection and coil extraction remains the preferred management option for recurrent intracranial aneurysms, resulting in high obliteration rates, long-term occlusion stability, and low morbidity/mortality. In conclusion, to bring a satisfactory outcome, the multidisciplinary management of recurrent intracranial aneurysms after endovascular treatment should be adjusted to aneurysm morphology/size/location, and individualized according to patient needs.
Sažetak (hrvatski)
Mikrokirurški i endovaskularni postupci podjednako su uspješne metode liječenja intrakranijskih aneurizma. Ipak, u novije se vrijeme u njihovom liječenju sve više rabe različite endovaskularne metode zbog svoje minimalne invazivnosti. Međutim, ovi su terapijski postupci povezani s povećanim rizicima recidivirajućeg aneurizmatskog rasta i ponovne rupture, što pobuđuje potrebu odabira najpovoljnijih strategija za sprječavanje ovakvih rizika. Čini se kako je mikrokirurško selektivno postavljanje klipse na vrat recidivirajuće aneurizme najprikladnija metoda izbora, unatoč tomu što je tehnički izazovna zbog zahtjevnog oblika aneurizme nastalog uslijed prethodnog postavljanja zavojnica u aneurizmatsku vreću. Prikazujući ilustrativnu seriju bolesnika, u radu predstavljamo naša iskustva u liječenju recidivirajućih intrakranijskih aneurizma nastalih nakon endovaskularnog liječenja te raspravljamo prednosti i nedostatke naknadnog mikrokirurškog liječenja temeljem pregleda literature. U skladu s rezultatima ovoga rada, čini se kako je pažljivo mikrokirurško selektivno postavljanje klipse na vrat aneurizme s resekcijom aneurizmatske vreće i uklanjanjem zavojnica ili bez toga preporučena mogućnost liječenja recidivirajućih intrakranijskih aneurizma, koja osigurava visok stupanj obliteracije i dugoročnu stabilnost okluzije aneurizmatske vreće, kao i nisku razinu pobola i smrtnosti. Zaključujemo kako multidisciplinarno liječenje recidivirajućih intrakranijskih aneurizma nastalih nakon endovaskularnih postupaka treba biti prilagođeno obliku, veličini i smještaju aneurizme, kao i primjereno potrebama svakog pojedinog bolesnika.
Ključne riječi (engleski)
Ključne riječi (hrvatski)
Jezikengleski
Jezikhrvatski
Vrsta publikacijeZnanstveni rad - Izvorni znanstveni rad
Status objaveObjavljen
Vrsta recenzijeRecenziran - međunarodna recenzija
Verzija publikacijeObjavljena verzija rada (izdavačev PDF)
Naslov časopisaActa clinica Croatica
Brojčani podacivol. 60, br. 4, str. 695-702
p-ISSN0353-9466
e-ISSN1333-9451
DOIhttps://doi.org/10.20471/acc.2021.60.04.17
URN:NBNurn:nbn:hr:220:777011
Datum objave publikacije2021
URL dokumentahttps://hrcak.srce.hr/275505
Vrsta resursaTekst
Prava pristupaOtvoreni pristup
Uvjeti korištenjaIkona licence Imenovanje-Nekomercijalno-Bez prerada 4.0 međunarodna (CC BY-NC-ND 4.0)
Datum i vrijeme pohrane2024-06-25 07:39:35