Medknow Publications on behalf of the Neurological Society of India
Abstract
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
