• Shinjitsu Nishimura, Tomoaki Fujita, Hiroyuki Sakata, Emiko Hori, Masaki Mino, Michiharu Nishijima, and Hiroshi Midorikawa.
• Department of Neurosurgery, Aomori Prefectual Central Hospital, 2-1-1 Higashi-Tsukurimichi, Aomori 030-8553, Japan.
• No Shinkei Geka. 2009 Aug 1; 37 (8): 757-63.

AbstractThe inpact of the International Subarachnoid Aneurysm Trial (ISAT) trial publication in 2002 and major technical advances in neuroimaging, endovascular devices and techniques have resulted in increasing numbers of patients with ruptured aneurysms undergoing endovascular coiling, as first-line treatment for aneurysm occlusion. We treated six cases of ruptured aneurysms with this strategy, with choice of clipping as as additional treatment following intentional partial coiling. In this series, patients ranged in age from 36 to 74 years and included one man and five women. Three aneurysms were located in AcomA, 1 in ACA, and 2 in MCA. The reasons for the choice of this strategy were clinical and angiographical spasm in 2, high general surgical risk in 2, and other reasons in 2 cases, respectively. The mean interval between the first partial coiling and final clipping was 33 days. All cases were successfully clipped without difficulties and coil removal were performed in 3 cases for follow up examination. It is proposed that the choice of this strategy contributes to progresses in overall outcomes in cases of aneurysmal subarachnoid hemorrhage.

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