Endovascular Treatment Outcomes in Patients with Residual Cerebral Aneurysmatic Filling after Open Surgery

Introduction: Regardless of the size of recurrent aneurysm, it is a cause of serious mortality and morbidity due to the risk of bleeding. In this study, the early and late clinical and radiological results, efficacy and safety of EVT methods were evaluated in recurrent or residual aneurysms who have previously undergone microsurgical clipping(MSC) or "wrapping" operation for cerebral aneurysm. Material and Methods: The data of patients at Ankara Numune Training and Research Hospital and Ankara City Hospital Neurosurgery Clinic between 2012 and 2022 were retrospectively analyzed. Gender, age, first operation dates, EVT dates and EVT methods were evaluated. Clinical outcomes were evaluated with Modified Rankin Score (mRS), while radiological outcomes were evaluated with O'Kelly-Marotta Classification (OKM) and Modified Raymond-Roy Classification (MRRC). In addition, treatment success, mortality and morbidity rates and complications were examined. Results: A total of 70 aneurysms were treated in 68 patients. While 44 of the patients were female (64.7%), 24 of them were male (35.3%). Complete occlusion (OKM-D, MRRC-1) was achieved in 64% of aneurysms; including near-total occlusion (OKM-C, MRRC-2), the success rate reached 92%. In our study, the permanent morbidity rate was 4.4% and the mortality rate was 1.4%. Conclusion: In our study, the postoperative clinical and radiological results of the patients were statistically satisfactory. However, the lack of data on posterior circulation aneurysms can be considered as the weakness of our study. Future studies with larger cohorts and extended follow-up will improve reliability.