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Procedure-related Complications during Endovascular Treatment of Intracranial Saccular Aneurysms. | LitMetric

AI Article Synopsis

  • The study assessed complications during endovascular coiling for intracranial aneurysms, focusing on intraprocedural aneurysm rupture (IAR), thromboembolism (TE), and early post-procedural rebleeding (PER).
  • From 2007 to 2015, complications occurred in 14% of treated aneurysms, with a higher incidence in patients with subarachnoid hemorrhage (SAH) compared to unruptured aneurysms (UIA).
  • The findings suggest that balloon-assisted coiling (BAC) can help mitigate the risks of complications and that factors like female gender and SAH are associated with higher complication rates during the procedure.

Article 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%, < 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 ( > 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 ( < 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.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5680079PMC
http://dx.doi.org/10.7461/jcen.2017.19.3.162DOI Listing

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