Coiling of very large or XXXX : long-term clinical and serial angiographic results.

@entity1 @entity510 @entity439 @entity432 @entity2300 @entity438
BACKGROUND AND PURPOSE: Initial complete occlusion of very large or @entity439 often cannot be accomplished, and most will partially reopen over time. This study was performed to assess the clinical and angiographic outcome of @entity1 with very large or @entity438 treated with detachable coils. METHODS: During 6 years, 29 @entity1 with 31 very large or giant (20-55-mm) @entity438 were initially treated with detachable coils. Nineteen @entity1 presented with @entity510 ( @entity510 ), and eight @entity1 had symptoms of mass effect. One @entity1 had an incidental @entity439 , and one @entity1 had an additional @entity439 . RESULTS: Twenty-three (79%) of 29 @entity1 had a good clinical outcome at a median follow-up of 50 months. One of 19 @entity1 presenting with @entity510 had repeat bleed (annual rebleeding rate, 1.45%). After initial coiling, seven of 31 @entity439 were @entity2300 ; this rate increased to 20 of 29 @entity439 at 6-month follow-up angiography. After 16 repeat coiling procedures in 13 @entity439 , 12 of 29 @entity439 in surviving @entity1 were still @entity2300 . After additional treatment other than coiling (parent-vessel occlusion and/or surgery) in eight @entity439 , three of 25 @entity439 in 24 surviving @entity1 were @entity2300 . Only 13 (42%) of 31 @entity439 had one coiling as a sole therapy. CONCLUSION: Coiling of very large or @entity439 can be considered. Long-term clinical outcomes were good in 79% of @entity1 . The stability of the coil mesh over time was poor, requiring repeat coiling, surgery, and/or @entity432 in 58% of the @entity439 primarily treated with coils.
