Abstract
The authors report on 12 patients with complex intracranial aneurysms treated with combined operative and endovascular methods. Five patients were treated surgically and then by endovascular therapy. The remainder were treated using endovascular techniques and then underwent craniotomy and surgical ligation of the aneurysm. Seven patients presented with subarachnoid hemorrhage. All of the remaining five patients exhibited aneurysms with complex anatomic configurations. Eleven of the aneurysms were completely occluded. One aneurysm was 90% occluded, without evidence of growth within 34 months after treatment. Outcomes were fair for one patient and excellent for the others. The combined use of endovascular and open surgical techniques represents the future treatment of cerebrovascular pathological conditions. As catheter-based technology has improved and endovascular treatment methods have evolved, cerebrovascular neurosurgeons and neuroradiologists have changed the way in which they manage complex cerebrovascular aneurysms, malformations, and fistulas. Lesions that previously were considered inoperable are now being treated...
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