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These authors analyzed data on 131 non-selected MCA aneurysms treated during a 6-year period. One month after treatment, permanent morbidity and mortality was 3.3% without significant differences according to technique used. The rate of recanalization was nearly 16%, also without differences according to technique, and re-treatment was needed in 7.6% of cases. A greater rate of complications occurred with balloon remodeling and only large aneurysm size predicted recanalization. The authors concluded that endovascular treatment of MCA aneurysms is safe, effective, and durable.

The long-term complications of coil treatment of giant intracranial aneurysms were assessed in 334 instances when treatment consisted of only coiling (225), stent-assisted coiling (88), parent vessel occlusion (14), or balloon-assisted coiling (7). The authors concluded that coiling of large and giant aneurysms has reasonable safety profiles with good clinical outcomes, but aneurysm reopening was common. Stent-assisted coiling had lower recurrence, retreatment, and new or recurrent hemorrhage rates with no additional morbidity compared with conventional coiling. Aneurysm size was a major determinant of recanalization, retreatment, new or recurrent hemorrhage, and poor outcome.