Recurrence

There are many unresolved questions in relation to endovascular therapy. Whilst GDC coiling, even partial, undoubtedly prevents re-bleeding in the short term, in the long term, efficacy is not yet known, particularly the long-term rebleeding rate. At best, the late recurrence is converted into an unruptured aneurysm. There is further controversy as recent papers [12,21] suggest that the rupture rate of an unruptured aneurysm is low and treatment unjustified.

Complete obliteration is observed in 50-80% of aneurysms with endovascular treatment. After surgery, complete occlusion is observed in 94% of aneurysms [22]. The risk of hemorrhage from incompletely occluded, surgically treated aneurysms is thought to be less than 1% per year.

The mechanisms of occlusion of an aneurysm by clipping and by coiling are obviously different. In a clipped aneurysm rest, the walls are closely apposed and the remaining aneurysm is completely excluded from the circulation [22]. In contrast, using the endovascular technique, the walls are kept apart by the coils, allowing blood to flow into the sac. In the long term, remnants lead to recurrence. Malesh [15] followed up 100 patients who underwent embolization of 104 aneurysms. Mid-term outcome was obtained for 94 patients (2-6 years, average 3.5 years). Twenty patients required further non-GDC procedures (clipping in 9, parent artery sacrifice in 11).

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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