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[Aneurysmal rupture during embolization with Guglielmi detachable coils]
J Peltier1, A Nowtash, P Toussaint
1Service de Neurochirurgie, CHU Nord, Amiens. jojo.peltier@caramail.com
Neuro-Chirurgie
|November 18, 2004
Summary
Aneurysmal rupture during embolization is rare, occurring in 1.9% of cases. Prompt recognition and continued coil deposition can lead to successful outcomes despite this feared complication.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Cerebrovascular Disease
Context:
- Endovascular coiling is a common treatment for acute cerebral aneurysms.
- Intraprocedural aneurysmal rupture is a severe complication during embolization.
- Understanding the frequency, causes, and outcomes of this event is crucial.
Purpose:
- To determine the frequency, causes, management, and outcome of aneurysmal rupture during embolization.
- To present clinical experience with this feared complication.
Summary:
- Retrospective review of 314 endovascular coiling cases identified 6 instances of intraprocedural aneurysmal rupture (1.9% prevalence).
- Rupture occurred during microcatheterization (1 case) or coil deposition (5 cases), often due to coil detachment.
- Outcomes included 33% mortality and 16.7% morbidity, though successful completion of embolization was possible in some cases.
Impact:
- Highlights the rarity and potential severity of aneurysmal rupture during embolization.
- Demonstrates that immediate intervention with further coil deposition can be effective.
- Informs management strategies for this critical complication in cerebrovascular interventions.