[A case of intrasacular thrombosis during the coil embolization procedure for a ruptured cerebral aneurysm].

A case of intrasacular thrombosis during the coil embolization procedure for a ruptured cerebral aneurysm is presented. A 50-year-old man suffered sudden onset of headache and unconsciousness. Computed tomography demonstrated diffuse subarachnoid hemorrhage and magnetic resonance angiography (MRA) disclosed a basilar-right superior cerebellar artery aneurysm. The aneurysm was treated by endovascular coil embolization with Guglielmi detachable coil (GDC; Boston Scientific Corp., Natick, MA, USA). The diameter of the aneurysm sac was 3.7 mm X 2.7 mm at first, but during the coil delivery the aneurysm size was diminished by thrombosis in the sac. GDC-10 2 mm X 2 cm was able to be placed in the aneurysm successfully after additonal administration of heparin, and postembolization angiography revealed obliteration of the aneurysm. Fortunately, there was no ischemic complication and the patient was discharged without any neurological deficits. MRA study 7 months after treatment revealed no recurrence of the aneursym, but long-term follow-up will be needed because of the low packing density in the aneurysm. Thromboembolic complication is one of the main complications of aneurysm coil placement for ruptured both cerebral aneurysms, and unruptured cerebral aneurysms. The administration of anticoagulant and antiplatelet agents is necessary during coil embolization for ruptured cerebral aneurysms.