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Updated: Jun 10, 2026
07:21
Microsurgical Creation of Giant Bifurcation Aneurysms in Rabbits for the Evaluation of Endovascular Devices
Published on: September 8, 2023
Problems in endovascular procedures in acute ruptured intracranial aneurysms
T Shibuya1, H Kushi, K Kinoshita
1Department of Emergency and Critical Care Medicine, Nihon University School of Medicine; Tokyo, Japan.
Summary
Interlocking detachable coil (IDC) embolization effectively prevented rebleeding in patients with acute ruptured intracranial aneurysms. However, outcomes were impacted by small aneurysm size and severe atherosclerosis.
Area of Science:
- Neurosurgery
- Interventional Neurology
- Vascular Neurology
Background:
- Acute ruptured intracranial aneurysms, particularly those in the anterior circulation, present a significant neurosurgical challenge.
- Patients often present with poor neurological grades (Hunt & Kosnik IV-V), indicating severe clinical status.
- Effective treatment aims to prevent rebleeding while managing the high morbidity and mortality associated with these conditions.
Purpose of the Study:
- To evaluate the safety and efficacy of interlocking detachable coil (IDC) embolization for acute ruptured intracranial aneurysms.
- To assess immediate and follow-up outcomes, including aneurysm occlusion, rebleeding rates, and neurological status using the Glasgow Outcome Scale (GOS).
Main Methods:
- A cohort of fifteen patients with acute ruptured intracranial aneurysms underwent transfemoral endovascular embolization using IDC.
- Procedures were performed under local anesthesia, with aneurysmal obliteration assessed post-embolization.
- Patient outcomes were evaluated using the Glasgow Outcome Scale (GOS) and follow-up angiography.
Main Results:
- Immediate total aneurysmal occlusion was achieved in 11 patients (73.3%) with no rebleeding during follow-up.
- Complications included coil migration in two patients with severe atherosclerosis and one intraprocedural rupture due to coil detachment failure.
- Follow-up angiography revealed coil compaction in two patients, with one experiencing deterioration due to aneurysm rupture.
Conclusions:
- Interlocking detachable coil (IDC) embolization is a viable endovascular strategy for preventing rebleeding in acute ruptured intracranial aneurysms.
- The study highlights limitations related to very small aneurysm size and the presence of severe atherosclerosis, which may influence procedural success and patient outcomes.
- Despite complications, a significant proportion of patients achieved total occlusion and remained free from rebleeding, though overall neurological outcomes varied widely.
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