Parent artery occlusion was the classic therapy; now the stent-assisted coil embolization has become available in recent years, but the optimal therapy is under debate.
Stent-assisted coiling may not be superior to parent artery occlusion in selected patients after short-term follow-up. Parent artery occlusion is a simple, safe and effective treatment for large/giant internal carotid aneurysms 1).
ICA occlusion for large and giant aneurysms after angiographic test occlusion was safe and effective. Two-thirds of eligible patients passed the angiographic test. Most aneurysms shrunk, and most cranial nerve dysfunctions were cured or improved 2).
Retrograde suction decompression
1)
Li H, He XY, Li XF, Zhang X, Liu YC, Duan CZ. Treatment of giant/large
internal carotid aneurysms: parent artery occlusion or stent-assisted coiling.
Int J Neurosci. 2016 Jan;126(1):46-52. doi: 10.3109/00207454.2014.992427. Epub
2015 Jan 7. PubMed PMID: 25565057.
2)
Bechan RS, Majoie CB, Sprengers ME, Peluso JP, Sluzewski M, van Rooij WJ.
Therapeutic Internal Carotid Artery Occlusion for Large and Giant Aneurysms: A
Single Center Cohort of 146 Patients. AJNR Am J Neuroradiol. 2016
Jan;37(1):125-9. doi: 10.3174/ajnr.A4487. Epub 2015 Aug 20. PubMed PMID:
26294643.