Procedure-related Complications during Endovascular Treatment of Intracranial Saccular AneurysmsProcedure-related Complications during Endovascular Treatment of Intracranial Saccular Aneurysms
- Other Titles
- Procedure-related Complications during Endovascular Treatment of Intracranial Saccular Aneurysms
- Authors
- 안재민; 오재상; 윤석만; 심재현; 오혁진; 배학근
- Issue Date
- 2017
- Publisher
- 대한뇌혈관외과학회
- Keywords
- Aneurysm; Coil embolization; Intraprocedural aneurysm rupture; Thromboembolism
- Citation
- Journal of Cerebrovascular and Endovascular Neurosurgery, v.19, no.3, pp.162 - 170
- Journal Title
- Journal of Cerebrovascular and Endovascular Neurosurgery
- Volume
- 19
- Number
- 3
- Start Page
- 162
- End Page
- 170
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/8120
- DOI
- 10.7461/jcen.2017.19.3.162
- ISSN
- 2234-8565
- 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.
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