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 ORIGINAL ARTICLE
Year : 2011  |  Volume : 59  |  Issue : 3  |  Page : 369--372

Intraprocedural cerebral aneurysm rupture during endovascular coiling


Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China

Correspondence Address:
Peizhuo Zang
Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Heping Beier Street, 110001, Shenyang
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.82736

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Background : Intraprocedural aneurysm rupture is considered to be one of the most formidable complications of the endovascular treatment of cerebral aneurysms and is associated with high mortality. Objective : To report the clinical outcomes of cerebral aneurysms that ruptured during endovascular coiling. Patients and Methods : Over a period of six years, 559 endovascular embolizations were performed in 467 patients, with 507 cerebral aneurysms. Intraprocedural aneurysm rupture occurred in 14 cases (mean aneurysm size, 3.8 mm). Follow-up angiograms, at a minimum of three months post embolization, were available in 11 living patients. Acute and follow-up results were reviewed. Results : The difference in the rates of aneurysm perforation during endovascular coiling between ruptured and unruptured aneurysms was significant (P < 0.05). There were three (21.4%) deaths related to this complication and three (21.4%) patients developed new deficits (modified Rankin Scale scores 1 to 2). Acute results of embolization were: complete occlusion in eight (57.1%), neck remnant in two (14.3%), and incomplete occlusion in four (28.6%) patients. Long-term follow-up results in 11 living patients were: major recanalization in one (9.1%), minor recanalization in one (9.1%), and stable occlusion in nine (81.8%). Conclusion : Intraprocedural aneurysm rupture frequently occurs in small aneurysms and appears to be associated with relatively high rates of mortality.






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