Embolisation of recently ruptured intracranial aneurysms

Area of Science:

• Neurosurgery
• Interventional Neuroradiology
• Neurology

Background:

• Subarachnoid haemorrhage (SAH) is a critical condition often caused by ruptured cerebral aneurysms.
• Surgical clipping may not be feasible for all patients, necessitating alternative treatments.
• Endovascular coiling has emerged as a primary treatment modality for select aneurysm cases.

Purpose of the Study:

• To evaluate the safety and efficacy of endovascular coil embolisation for ruptured aneurysms.
• To assess treatment outcomes in patients with aneurysms unsuitable for craniotomy and clipping.
• To compare the results with existing surgical series.

Main Methods:

• Coil embolisation was performed within three weeks of subarachnoid haemorrhage onset.
• Seventy-five consecutive patients with ruptured aneurysms unsuitable for craniotomy were included.
• Patient outcomes were assessed using Glasgow Outcome Scores at six weeks.

Main Results:

• Successful treatment was achieved in 69 out of 75 patients (92%).
• Procedure-related complications occurred in 10 patients, with 3 permanent neurological deficits and 1 death (4.8% mortality).
• Glasgow Outcome Scores at six weeks indicated favorable outcomes for a majority of patients.

Conclusions:

• Endovascular coil embolisation is a safe and effective treatment for ruptured aneurysms.
• The results are comparable to surgical interventions, even with a high proportion of posterior circulation aneurysms.
• Coil embolisation provides a viable alternative for patients with complex aneurysms unsuitable for open surgery.