Coil embolization of intracranial aneurysms, the LSUHSC-S experience

We evaluated and compared patient selection and outcome statistics during the first 18 months of the Louisiana State Health Sciences Center-Shreveport (LSUHSC-S) neurointerventional suite operation, specifically focusing on endovascular occlusion of intracranial aneurysms.

A retrospective analysis of 67 patients with 68 cerebral aneurysms that were treated at the LSUHSC-S from July 2006 to December 2007 was conducted. All procedures were performed with the patients under general anesthesia and with systemic heparinization using live simultaneous roadmapping. The presence of residual aneurysmal filling was determined at the end of each procedure.

A total of 67 patients underwent 70 endovascular coil embolization procedures for 68 intracranial aneurysms. Mean age of the patients was 51 years (range 15-89 years). There was a slight female preponderance (58.2% vs 41.8%). The vast majority of aneurysms undergoing coil embolization had ruptured (83.8%). Most were located in anterior circulation and (77.9%) were small (< 10 mm) in size (91.2%). Endovascular remodeling was attempted in 21 procedures (30%). Following embolization, complications were observed in 20 cases (28.6%). Though a greater proportion of complications occurred following procedures involving the posterior circulation, there was no statistical significance (p = 0.126, Chi-Square). Complete post-embolization occlusion was achieved with 33 aneurysms (47%). Near complete occlusion (> 90%) was seen in 65 (91.4%). There was no statistical association between location of the aneurysm and incomplete post procedure occlusion (p = 0.794, Chi-square).

Our experience with coil embolization of intracranial aneurysms shows encouraging results and mirrors published rates of immediate post procedures near complete occlusion rates of approximately 90%.