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Updated: Mar 12, 2026
Simulator Training for Endovascular Neurosurgery
Published on: May 6, 2020
Results of Endovascular Coil Embolization Treatment for Small (≤ 5 mm) Unruptured Intracranial Aneurysms
Siwoo Lee1, Tae-Sik Gong1, Yong-Woo Lee1
1Department of Neurosurgery, Presbyterian Medical Center, Jeonju, Korea.
Objective:
Researchers and clinicians have been unable to fully elucidate the natural course of and proper treatment for unruptured intracranial aneurysms (UIAs) smaller than or equal to 5 mm, particularly with regard to whether close observation or surgery is more appropriate. In this retrospective study, we evaluated the safety and efficacy of endovascular coil embolization of small (≤ 5 mm) asymptomatic UIAs by analyzing outcomes and complications associated with the procedure.
Materials And Methods:
We analyzed data from 150 patients with small asymptomatic UIAs (≤ 5 mm) treated with coil embolization between January 2011 and December 2015. Three-dimensional angiography was used to measure aneurysm size. We evaluated procedure-related morbidity and mortality, immediate post-operative angiographic results, brain computed thomography follow-up results on post-operative day one, and clinical progress.
Results:
UIAs occurred primarily in the anterior circulation area (142 cases, 94.67%), though eight patients exhibited UIAs of the posterior circulation. Following coil embolization, aneurysms with complete occlusion were observed in 137 cases (91.3%). Partial occlusion occurred in five cases (3.33%), while the procedure had failed in eight cases (5.33%). Procedure-related morbidity and mortality were five cases (3.33%) and zero cases, respectively.
Conclusion:
The endovascular treatment of small asymptomatic UIAs is associated with good short-term outcomes without permanent neurologic complications as well as low overall complication and morbidity rates. Thus, the procedure should be considered for patients with smaller asymptomatic UIAs.
Insights
Endovascular coil embolization offers safe and effective treatment for small, asymptomatic unruptured intracranial aneurysms (UIAs) ≤ 5 mm, showing good short-term outcomes and low complication rates.
Area of Science:
- Neurosurgery
- Interventional Neurology
- Vascular Neurology
Background:
- Unruptured intracranial aneurysms (UIAs) smaller than or equal to 5 mm present diagnostic and therapeutic challenges.
- The optimal management strategy, whether observation or intervention, remains debated for these small asymptomatic UIAs.
Purpose of the Study:
- To evaluate the safety and efficacy of endovascular coil embolization for small (≤ 5 mm) asymptomatic UIAs.
- To analyze procedural outcomes, including morbidity, mortality, and occlusion rates.
Main Methods:
- Retrospective analysis of 150 patients with small asymptomatic UIAs treated with coil embolization (2011-2015).
- Assessment of procedure-related morbidity and mortality.
- Evaluation of immediate post-operative angiographic results and short-term clinical follow-up.
Main Results:
- Complete aneurysm occlusion was achieved in 91.3% of cases.
- Procedure-related morbidity was 3.33%, with no reported mortality.
- Anterior circulation aneurysms were most common (94.67%).
Conclusions:
- Endovascular treatment of small asymptomatic UIAs yields favorable short-term outcomes.
- The procedure is associated with low complication and morbidity rates.
- Coil embolization is a viable treatment option for select patients with small asymptomatic UIAs.
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