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Procedure-related Complications during Endovascular Treatment of Intracranial Saccular Aneurysms

Jae-Min Ahn1, Jae-Sang Oh1, Seok-Mann Yoon1

  • 1Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.

Journal of Cerebrovascular and Endovascular Neurosurgery
|November 22, 2017
PubMed

Insights

Endovascular coiling for intracranial aneurysms has a 14% complication rate, higher in subarachnoid hemorrhage (SAH) cases. Balloon-assisted coiling (BAC) aids recovery from intraprocedural aneurysm rupture (IAR).

Area of Science:

  • Neurosurgery
  • Interventional Radiology
  • Vascular Neurology

Background:

  • Endovascular coiling is a common treatment for intracranial aneurysms.
  • Procedure-related complications can impact patient outcomes.

Purpose of the Study:

  • To evaluate the rates and outcomes of major procedure-related complications during endovascular coiling.
  • To identify risk factors associated with these complications.

Main Methods:

  • Retrospective analysis of 436 intracranial saccular aneurysms treated between 2007 and 2015.
  • Complications categorized as intraprocedural aneurysm rupture (IAR), thromboembolism (TE), and post-procedural early rebleeding (PER).
  • Multivariate analysis used to identify risk factors for complications.

Main Results:

  • Overall complication rate was 14% (61/436 aneurysms).
  • Complication rates were significantly higher in subarachnoid hemorrhage (SAH) patients (20%) compared to unruptured intracranial aneurysms (UIA) (6%).
  • Female gender, SAH, and intraventricular hemorrhage were associated with increased complication risk.

Conclusions:

  • Endovascular coiling, while minimally invasive, carries a notable risk of complications, particularly in SAH cases.
  • Balloon-assisted coiling (BAC) may improve outcomes following intraprocedural aneurysm rupture (IAR).
  • Intra-arterial tirofiban is effective for thromboembolism (TE), but early rebleeding risk in SAH requires careful consideration.
Abstract

Keywords:
AneurysmCoil embolizationIntraprocedural aneurysm ruptureThromboembolism

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