内頸動脈-海綿静脈洞部巨大動脈瘤の治療戦略  [in Japanese] Strategy of Treatment for Giant Aneurysm in the Cavernous Portion of the Internal Carotid Artery  [in Japanese]

We report 17 patients with symptomatic giant aneurysms in the cavernous portion of the internal carotid artery (ICA) who were treated by trapping the ICA on either side of the aneurysmal orifice or proximal occlusion using detachable coils. In all 17 patients, the ICA was sacrificed; 9 patients subsequently underwent bypass surgery (STA-MCA bypass, n=7; high-flow bypass with vein graft, n=1 and median flow bypass with radial artery graft, n=1). The other 8 patients did not. Coil trapping was performed in 10 patients and proximal occlusion in 7 patients. In 16 patients, there were no ischemic complications after treatment; 1 patient who had been treated by proximal occlusion of the ICA developed transient ischemia due to an intraaneurysmal thrombus. Cranial nerve palsies were improved in 15 patients. ICA trapping or proximal occlusion using detachable coils was a highly successful treatment method, and we found the detachable coils effective and easy to use in this series of 17 patients.