Endovascular treatment of saccular intracranial aneurysm.

BACKGROUND: Since September 1992, 295 aneurysms in 217 patients have been treated by detachable coils (GDC) in the Department of Neuroradiology and Neurosurgery of Lariboisiere Hospital. METHODS: They included four groups of cases: ruptured aneurysms which were treated in early period (45%), ruptured aneurysms treated after the 30th day after haemorrhage (29%), unruptured aneurysms incidentally discovered (22%); and cases without haemorrhage but with a mass effect inducing a neurological deficit. RESULTS: In the group of patients treated in early period, the frequency and date of vasospasm occurrence before or after treatment is of major interest. Complete occlusion could be obtained in 78%, subtotal (80%) in 19% and partial in 3%. The technical complication rate was 18.60% with only 3.05% permanent neurological deficit. The overall results including technical complications and others (vasospasm, hydrocephalus) show 80.2% good results, 5.81% moderate disability, 2.3% severe disability and 11.6% deaths. CONCLUSIONS: The overall results of this series of patients are excellent and may be compared to surgical series. Comparison has been made with large series of well know neurosurgeons and the rates of good and excellent anatomical and clinical results obtained by endovascular treatment of intracranial aneurysm are similar or better than those provided by surgical treatment.