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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">De una serie aproximada a los 50 procedimientos endovasculares para tratamiento de aneurismas intracraneales llevados a cabo en el Departamento de Neuroangiograf&#237;a Diagn&#243;stica y Terap&#233;utica de nuestro hospital durante el a&#241;o 1994&#44; existi&#243; un peque&#241;o grupo en los que el procedimiento no fue satisfactorio y tuvo que abandonarse&#46; En tres de estos pacientes fue requerida la valoraci&#243;n neuroquir&#250;rgica urgente&#46; En dos de ellos se confirm&#243; la rotura del saco aneurism&#225;tico al ser penetrada la pared por el tracker o gu&#237;a del coil &#40;Guglielmi detachable coil&#41;&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La valoraci&#243;n cl&#237;nica de estos pacientes tras el intento de tratamiento endovascular queda artefactada habitualmente por el uso de agentes anest&#233;sicos&#46; Sin embargo resulta de gran ay&#250;da para decidir el momento de la intervenci&#243;n quir&#250;rgica la TAC craneal inmediata&#44; el Doppler transcraneal y la propia angiograf&#237;a cerebral&#46; Se insiste en la necesidad de conjuntar los criterios del neurocirujano y neurorradi&#243;logo intervencionista para indicar en cada paciente la opci&#243;n m&#225;s favorable de tratamiento&#46;</p>"
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        "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">From a group around fifty interventional endovascular procedures performed in our Hospital&#39;s Department of Neuroangiograf&#237;a Diagn&#243;stica y Terap&#233;utica during 1994&#44; there is a small group of patients in which the procedure had to be interrupted due to technical difficulties&#46; In three of these patients urgent neurosurgical consultation was required&#46; Two patients had perforated the aneurysm sac with the tracker &#40;Guglielmi detachable coil&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The clinical evaluation of these patients is difficult due to the anesthesia&#46; Nevertheless the inmediate CAT scan&#44; the transcraneal Doppler&#44; and the cerebral angiography are of great help to decide the best time for surgical clipping&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">We insist upon the need to combine the neuroradiological interventionist and the neurosurgeon criteria to recommend the best treatment on each case&#46;</p>"
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Vol. 6. Núm. 4.
Páginas 305-310 (enero 1994)
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Vol. 6. Núm. 4.
Páginas 305-310 (enero 1994)
Qué hacer cuando el tratamiento endovascular de los aneurismas intracraneales fracasa. ¿Cuándo realizar el tratamiento quirúrgico?
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1438
M. Clavel Escribano
Servicio de Neurocirugía del Hospital General de Cataluña. Barcelona
Este artículo ha recibido
Información del artículo
Resumen

De una serie aproximada a los 50 procedimientos endovasculares para tratamiento de aneurismas intracraneales llevados a cabo en el Departamento de Neuroangiografía Diagnóstica y Terapéutica de nuestro hospital durante el año 1994, existió un pequeño grupo en los que el procedimiento no fue satisfactorio y tuvo que abandonarse. En tres de estos pacientes fue requerida la valoración neuroquirúrgica urgente. En dos de ellos se confirmó la rotura del saco aneurismático al ser penetrada la pared por el tracker o guía del coil (Guglielmi detachable coil).

La valoración clínica de estos pacientes tras el intento de tratamiento endovascular queda artefactada habitualmente por el uso de agentes anestésicos. Sin embargo resulta de gran ayúda para decidir el momento de la intervención quirúrgica la TAC craneal inmediata, el Doppler transcraneal y la propia angiografía cerebral. Se insiste en la necesidad de conjuntar los criterios del neurocirujano y neurorradiólogo intervencionista para indicar en cada paciente la opción más favorable de tratamiento.

Palabras clave:
Aneurismas intracraneales
Tratamiento endovascular
Guglielmi coil
Clipaje
Summary

From a group around fifty interventional endovascular procedures performed in our Hospital's Department of Neuroangiografía Diagnóstica y Terapéutica during 1994, there is a small group of patients in which the procedure had to be interrupted due to technical difficulties. In three of these patients urgent neurosurgical consultation was required. Two patients had perforated the aneurysm sac with the tracker (Guglielmi detachable coil).

The clinical evaluation of these patients is difficult due to the anesthesia. Nevertheless the inmediate CAT scan, the transcraneal Doppler, and the cerebral angiography are of great help to decide the best time for surgical clipping.

We insist upon the need to combine the neuroradiological interventionist and the neurosurgeon criteria to recommend the best treatment on each case.

Key words:
Intracranial aneurysms
Endovascular treatment
Guglielmi detachable coils (GDC)
Surgical clippingo

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