الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Intracranial saccular aneurysms represent the most common etiology of non traumatic SAH with about 75- 80 % of SAH resulting from ruptured aneurysms. This prospective study aimed to evaluate the angiographic and clinical outcome of small and large intracranial aneurysm coiling under local infilteration anesthesia. Our study included a total number of twenty five patients performed in Kohnan hospital (Japan) and Mansoura University Hospital (Egypt), 20 and 5 cases respectively. Twenty five patients underwent twenty eight treatment sessions under local anesthesia for twenty seven aneurysms. This study included coiling of both ruptured and unruptured aneurysms. The main presentation of cases was incidentally discovered unruptured aneurysms. The main risk factor encountered in the study group was hypertension in both sectors and positive family history in Japanese sector only. The most common site of aneurysm in both sectors of the study was AcomA aneurysm followed by PcomA aneurysms in the Japanese sector only. Technically, all aneurysms could be approached and coiled under local anesthesia with no procedure related limitations. The initial angiographic outcome of all patients was complete obliteration in 55%, while neck remnant occurred in 45%. At follow up, complete obliteration occurred in 61.5 %, neck remanant 27%, and body filling 11.5%. These results are comparable to other studies.Three aneurysms showed recanalization (BF) at follow up angiograms but only one refused further treatment; one underwent successful recoiling and the last one already in preparation to do recoiling but not performed yet. The clinical outcome was excellent; GOS 5 was for all except one patient in whom GOS was 4 at one year. Procedure related complications were 32%, all are transient with no permanent neurodeficit at hospital discharge and no mortalities were encountered Endovascular coiling of intracranial aneurysms is safe and feasible to be done under local anesthesia in well trained hands when the procedure is expected to be short in cooperative patients.