Outcome of endovascular treatment of giant aneurysm

Introduction: Very large and giant aneurysms are among the most challenging cerebrovascular pathologies in neurosurgery. The risk of aneurysmal rupture compounds with an increase in the size of the aneurysm thus warranting appropriate intervention. Objective: To analyze the outcome of endovascular treatment of giant aneurysm. Materials and Methods: A retrospective study was conducted at the Department of Neurosurgery. 35 cases were selected from the database with radiological diagnoses of giant aneurysm referred to our departments from 2016 to 2023. Results: The patients mainly belonged to >60 years age group (37.14%) and had a mean age of 49 years, with a slight female preponderance (57.14%). Aneurysms were mainly located in patients who had left internal carotid artery (ICA) supraclinoid aneurysms (14.29%) and right middle carotid artery (MCA) bifurcation aneurysms (14.29%). The patients predominantly underwent simple coiling (45.7%) and stent-assisted coiling (42.8%). Of 35 patients, 2 (5.7%) died. The recurrence was higher in posterior circulation aneurysms with, 75% in basilar top aneurysms (3 out of 4 cases), 50% in posterior communicating artery aneurysms (one out of 2 cases), 37.9% in remaining cases (11 out of 29 patients). Conclusion: Giant aneurysm is associated with reasonably high morbidity and mortality. The aneurysms are found most often in the anterior circulation, while the recurrence is mainly observed in the posterior circulation have more chances of recurrence. However, favourable outcome was frequently observed (94.3%).