Periprocedural complications associated with endovascular embolisation of intracranial ruptured aneurysms with matrix...

Matrix is a type of bioactive coil expected to produce healing of cerebral aneurysms. We reviewed periprocedural complications associated with endovascular embolisation of ruptured intracranial aneurysms with matrix coils and evaluated the effects of matrix coils.

From October 2003 to September 2005, a total of 102 patients with 102 ruptured aneurysms and ten unruptured aneurysms underwent embolisations with matrix coils. We reviewed the medical records, radiographical studies and endovascular procedures to evaluate the morbidity and mortality related to ruptured aneurysm coiling.

16 complications (15.7 percent) occurred, of which 14 were in the anterior circulation and two in the posterior circulation. Complications included nine intraprocedural ruptures (8.8 percent), three thromboembolism (2.9 percent), one coil migration (1.0 percent) and three parent vessel occlusions (2.9 percent). Six complications had no neurological consequences, three were with transient deficits, six resulted in persistent neurological deficits, and one caused the patient to die. No complication was associated with balloon remodelling technique, and coil migration occurred during one of the neuroform-assisted embolisations. Procedural-related neurological morbidity and mortality for all 102 embolisations of ruptured aneurysms were 5.9 percent and 1.0 percent, respectively.

Endovascular treatment of ruptured intracranial aneurysms with matrix coils is as safe as with bare platinum coils. Matrix coil does not increase the risk of thromboembolism. However, we must be cautious when we embolise small aneurysms with matrix coils, especially when the aneurysms are less than 5 mm in diameter.