Combined endovascular treatment for both intracranial aneurysm and symptomatic XXXX .

@entity1 @entity510 @entity887 @entity439 @entity1031 @entity432 @entity2553 @entity204 @entity1756
BACKGROUND AND PURPOSE: The best strategy for treatment of @entity510 due to @entity1756 is obliteration of the @entity439 as soon as possible. Early surgery is desirable if the @entity1 does not develop severe @entity2553 or is clinically stable. However, if the @entity1 has already developed severe @entity2553 on admission, surgery may carry the risk of increasing the severity. We evaluated the safety and effectiveness of combined Guglielmi detachable coil (GDC) @entity887 and angioplasty in a single session for the treatment of @entity1756 associated with symptomatic @entity2553 . METHODS: From January 1992 to January 2001, 12 consecutive @entity1 with @entity1756 associated with symptomatic @entity2553 were treated. @entity1 were classified as Hunt and Hess grade 2 (n = 1), 3 (n = 6), 4 (n = 4), or 5 (n = 1) and Fisher CT group 2 (n = 1), 3 (n = 10), or 4 (n = 1). They underwent GDC @entity439 and balloon angioplasty (n = 6), intraarterial papaverine infusion (n = 2), or both (n = 4) in a single session. In nine @entity1 , @entity439 coil occlusion was performed first. RESULTS: @entity432 was achieved in eight @entity1 , a small neck remnant persisted in three, and @entity887 was incomplete in one @entity1 . In all @entity1 , angiographic improvement of @entity2553 was obtained. In one @entity1 , a @entity1031 occurred and was treated with urokinase. Clinical outcomes at discharge were good recovery in six, moderate disability in two, severe disability in three, or @entity204 in one. CONCLUSION: Endovascular treatment can be the first therapeutic option for @entity1756 associated with severe @entity2553 on admission. It offers some advantages over surgery in this setting, but these are balanced by the risk of @entity1031 .
