Endovascular Coil Embolization of 435 Small Asymptomatic Unruptured Intracranial Aneurysms: Procedural Morbidity and Patient Outcome

Abstract

BACKGROUND AND PURPOSE:Whether treatment of small asymptomatic aneurysms is appropriate or not remains controversial. We performed a retrospective study on the procedural morbidity and mortality of coil embolization of small asymptomatic unruptured intracranial aneurysms (UIAs) to obtain a more generalized estimate of procedural risk.

Endovascular Therapy of 500 Small Asymptomatic Unruptured Intracranial Aneurysms

“…There have been a few reports that endovascular therapy of very small intracranial aneurysms (Յ3 mm) has a high risk of intraprocedural aneurysmal rupture. 4,17,18 In our series, the risk of intraprocedural aneurysmal rupture of very small aneurysms (Յ3 mm) was not significantly high. On the other hand, the failure rate was significantly high in the very small aneurysms.…”

“…Im et al 4 reported results of endovascular therapy in 435 small asymptomatic UIAs. There were a total of 44 procedure-related complications (10.1%): 24 thromboembolisms, 11 coil protrusions or herniations into the parent vessel, 4 intraprocedural aneurysmal ruptures, 3 device-related complications, and 2 femoral-access complications.…”

“…In the ATENA study, 14 the 1-month morbidity and mortality rates were 1.7% and 1.4%, respectively. Im et al 4 reported that the procedurerelated permanent morbidity rate of 358 small asymptomatic UIAs was 0.27% and the mortality was zero.…”

“…4 Therefore, precise risk evaluations of endovascular therapy of small asymptomatic UIAs have not yet been established. The purpose of this study was to report the treatment results of endovascular therapy of small asymptomatic UIAs and to elucidate the procedural feasibility, clinical outcomes, and procedurerelated risks.…”

The Characteristics and Risk Factors of Headache Development after the Coil Embolization of an Unruptured Aneurysm

“…Preparation for, and the technical details of, the procedure were conventional and were previously described in detail. [1][2][3][4] All aneurysm embolizations were performed using detachable platinum coils, including the Guglielmi (Boston Scientific, Fremont, California), MicroPlex (MicroVention, Aliso Viejo, California), and Axium (ev3, Irvine, California) coils. Modified coils, such as the Matrix (Boston Scientific) and HydroCoil (MicroVention), were not used.…”