Procedure-related Complications during Endovascular Treatment of Intracranial Saccular Aneurysms.
10.7461/jcen.2017.19.3.162
- Author:
Jae Min AHN
1
;
Jae Sang OH
;
Seok Mann YOON
;
Jae Hyun SHIM
;
Hyuk Jin OH
;
Hack Gun BAE
Author Information
1. Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea. metatron1324@hotmail.com
- Publication Type:Original Article
- Keywords:
Aneurysm;
Coil embolization;
Intraprocedural aneurysm rupture;
Thromboembolism
- MeSH:
Aneurysm*;
Embolization, Therapeutic;
Female;
Hemorrhage;
Humans;
Incidence;
Intracranial Aneurysm;
Logistic Models;
Multivariate Analysis;
Risk Factors;
Rupture;
Subarachnoid Hemorrhage;
Thromboembolism
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2017;19(3):162-170
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: We evaluate the rates and outcomes of major procedure-related complications during coiling. MATERIALS AND METHODS: Between 2007 and 2015, 436 intracranial saccular aneurysms were treated. Complications are categorized as three types: intraprocedural aneurysm rupture (IAR), thromboembolism (TE), and post-procedural early rebleeding (PER). And we evaluated the risk factors of procedure related complications by multivariate analysis. RESULTS: Complications occurred in 61 aneurysms (14%). The overall incidence of complications in subarachnoid hemorrhage (SAH) was significantly higher than in unruptured intracranial aneurysm (UIA) (20% vs. 6%). The incidence of IAR and TE were higher in SAH than in UIA (IAR 12% vs. 4%, TE 7% vs. 3%, p < 0.05). Five PER occurred only in SAH. In 34 UIA which were treated with balloon-assisted coiling (BAC), all these patients had good recovery despite 3 patients had the IAR. The incidence of IAR and TE were not different between BAC and non-BAC groups (p > 0.05). All 7 patients who had IAR during BAC had good recovery. In multiple logistic regression analysis, female gender, SAH, and intraventricular hemorrhage were associated with procedure related complication (p < 0.05). CONCLUSION: Endovascular coil embolization is a minimally invasive procedure, but incidence of its complication is not low, especially in SAH. BAC can be a good tool to avoid poor outcome from unexpected IAR during coiling. While IA tirofiban injection is a useful therapy in TE during coiling, sometimes we are aware of the risk of the early rebleeding in SAH patients.
