Factors related to adverse events during endovascular coil embolization for ruptured cerebral aneurysms

2020 ◽  
Vol 12 (6) ◽  
pp. 605-609 ◽  
Author(s):  
Hirotoshi Imamura ◽  
Nobuyuki Sakai ◽  
Tetsu Satow ◽  
Koji Iihara
Keyword(s):  
Risk Factors ◽  
Adverse Events ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Initial Result ◽  
World Federation ◽  
Ischemic Complications ◽  
Endovascular Coil Embolization ◽  
Ischemic Complication ◽  
Wide Neck

Background and purposeThe risk factors for adverse events for example, intraprocedural rupture (IPR), ischemic complication within 24 hours, and rebleeding after endovascular coil embolization for a ruptured cerebral aneurysm remain unclear. The aim of this study was to identify significant associated risk factors.MethodsWe retrospectively evaluated data from 5358 patients listed on the Japanese Registry of Neuroendovascular Therapy 3 during 2010–2014.ResultsIPR, ischemic complications, and rebleeding occurred during or after 221 (4.1%), 226 (4.2%), and 63 (1.2%) treatments, respectively. All of the adverse events were significantly associated with the patients’ poor outcomes at 30 days. Multivariate analysis revealed the factors independently related to these adverse events as follows: (1) for IPR: female sex, bifurcation type, <5 mm aneurysm, emergent surgery, local anesthesia, a balloon-assisted technique; (2) for an ischemic complication: poor World Federation World Federation of Neurological Societies (WFNS) grade, wide neck, and stent-assisted technique; (3) for rebleeding: poor WFNS grade, bifurcation type, wide neck, and body filling as the initial result.ConclusionsKnowledge of the risk factors of endovascular coil embolization and paying attention to them are essential for patients’ safe treatment and good outcomes.

scholarly journals Risk factors for coil protrusion into the parent artery and associated thrombo-embolic events following unruptured cerebral aneurysm embolization

2015 ◽  
Vol 21 (2) ◽  
pp. 178-183 ◽  
Author(s):  
Hideaki Ishihara ◽  
Shoichiro Ishihara ◽  
Jun Niimi ◽  
Hiroaki Neki ◽  
Yoshiaki Kakehi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Operation Time ◽  
Vascular Reconstruction ◽  
Parent Artery ◽  
Unruptured Cerebral Aneurysm ◽  
Aneurysm Embolization ◽  
Wide Neck

Objective Advances in vascular reconstruction devices and coil technologies have made coil embolization a popular and effective strategy for treatment of relatively wide-neck cerebral aneurysms. However, coil protrusion occurs occasionally, and little is known about the frequency, the risk factors and the risk of thrombo-embolic complications. Method We assessed the frequency and the risk factors for coil protrusion in 330 unruptured aneurysm embolization cases, and examined the occurrence of cerebral infarction by diffusion-weighted magnetic resonance imaging (DW-MRI). Result Forty-four instances of coil protrusion were encountered during coil embolization (13.3% of cases), but incidence was reduced to 33 (10% of cases) by balloon press or insertion of the next coil. Coil protrusion occurred more frequently during the last phase of the procedure, and both a wide neck (large fundus to neck ratio) (OR = 1.84, P = 0.03) and an inadequately stable neck frame (OR = 5.49, P = 0.0007) increased protrusion risk. Coil protrusions did not increase the incidence of high-intensity lesions (infarcts) on DW-MRI (33.3% vs 29% of cases with no coil protrusion). However, longer operation time did increase infarct risk ( P = 0.0003). Thus, tail or loop type coil protrusion did not increase the risk of thrombo-embolic complications, if adequate blood flow was maintained. Conclusion Coil protrusion tended to occur more frequently in cases of wide-neck aneurysms with loose neck framing. Moderate and less coil protrusion carries no additional thrombo-embolic risk, if blood flow is maintained, which can be aided by additional post-operative antiplatelet therapy.

scholarly journals Thromboembolic Events during Endovascular Coil Embolization of Cerebral Aneurysms

2006 ◽  
Vol 12 (1_suppl) ◽  
pp. 112-116 ◽  
Author(s):  
T. Ishibashi ◽  
Y. Murayama ◽  
T. Saguchi ◽  
M. Ebara ◽  
K. Irie ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adverse Event ◽  
Coil Embolization ◽  
Diffusion Weighted Imaging ◽  
Cerebral Aneurysms ◽  
Thromboembolic Events ◽  
Diffusion Weighted ◽  
Endovascular Coil Embolization ◽  
Intracerebral Aneurysm

Thromboembolic events was most important adverse event for coil embolization for intracerebral aneurysm. The present study investigated possible risk factors for thromboembolic events during coil embolization using diffusion-weighted imaging (DWI), comparing unruptured and ruptured lesions.

scholarly journals Acutely ruptured basilar artery bifurcation aneurysm, treated with simultaneous Cascade and Comaneci temporary-assisted coiling

2020 ◽  
pp. neurintsurg-2020-016320
Author(s):  
Alexander Sirakov ◽  
Radoslav Raychev ◽  
Pervinder Bhogal ◽  
Stanimir Sirakov
Keyword(s):  
Basilar Artery ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
Content Type ◽  
Compliant Structure ◽  
Bifurcation Aneurysm ◽  
Vessel Patency ◽  
Endovascular Coil Embolization ◽  
Video Player ◽  
Temporary Stent

Temporary stent-assisted coiling is an eligible approach for the treatment of acutely ruptured complex cerebral aneurysms. Improved material properties and industrial advances in braiding technology have led to the introduction of new stent-like devices to augment endovascular coil embolization. Such technology includes the Cascade and Comaneci neck-bridging devices. Both devices are manually controlled, non-occlusive and fully retrievable neck-bridging temporary implants. The braided nature and the ultra-thin wire, compliant structure of their bridging meshes helps maintain target vessel patency during coil embolization. In this video (video 1) we demonstrate the straightforward combination of two temporary neck-bridging devices for the embolization of an acutely ruptured aneurysm of the basilar artery. Technical success and complete embolization of the aneurysm were recorded at the final angiography. In this technical video we discuss the technical nuances of the Comaneci and Cascade coil embolization.Video 1

scholarly journals Coil Knotting during Endovascular Coil Embolization for Ruptured MCA Aneurysm

2008 ◽  
Vol 14 (3) ◽  
pp. 331-334
Author(s):  
S.C. Kwon ◽  
I.U. Lyo ◽  
S.H. Shin ◽  
J.B. Park ◽  
Y. Kim
Keyword(s):  
Coil Embolization ◽  
Present Report ◽  
Cerebral Aneurysms ◽  
Thromboembolic Events ◽  
Related Complication ◽  
Parent Vessel ◽  
Aneurysmal Rupture ◽  
Hemorrhagic Complications ◽  
Endovascular Coil Embolization ◽  
Mca Aneurysm

Complications during coil embolization of cerebral aneurysms include thromboembolic events, hemorrhagic complications related to procedural aneurysmal rupture and parent vessel perforation, and coil-related complications. The present report describes a rare coil-related complication involving spontaneous coil knotting.

The Effects of High Porosity Stent Configurations on Cerebral Aneurysm Hemodynamics

2011 ◽  
Author(s):  
Haithem Babiker ◽  
Justin Ryan ◽  
L. Fernando Gonzalez ◽  
Felipe Albuquerque ◽  
Daniel Collins ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Cerebral Aneurysm ◽  
Coil Embolization ◽  
Cerebral Aneurysms ◽  
High Porosity ◽  
Incomplete Filling ◽  
Aneurysmal Neck ◽  
Treatment For Cerebral Aneurysms ◽  
Wide Neck

Coil embolization is the most common endovascular treatment for cerebral aneurysms at many centers [1]. Nevertheless, the coiling of wide-neck aneurysms is a challenge. Incomplete filling of the aneurysmal sac due to coil configuration challenges and aneurysmal growth can often lead to recurrence. To assist treatment with coils, clinicians may deploy a high porosity stent in a staged process to act as a supporting bridge for coils. The stent is first deployed across the aneurysmal neck, and multiple coils are then deployed into the aneurysmal sac 6–8 weeks later [2]. Under certain circumstances, coil deployment is not possible and high porosity stents alone are used for treatment [2–3].

Stability of Cerebral Aneurysms After Stent-Assisted Coil Embolization

Neurosurgery ◽  
2015 ◽  
Vol 77 (2) ◽  
pp. 208-217 ◽  
Author(s):  
Won-Sang Cho ◽  
Hyun Sook Hong ◽  
Hyun-Seung Kang ◽  
Jeong Eun Kim ◽  
Young Dae Cho ◽  
...  
Keyword(s):  
Risk Factors ◽  
Propensity Score ◽  
Confidence Interval ◽  
Coil Embolization ◽  
Neurological Complication ◽  
Cerebral Aneurysms ◽  
Hazard Ratio ◽  
Stent Group ◽  
Incomplete Occlusion

Abstract BACKGROUND: The availability of stents has widened the indications of endovascular intervention for cerebral aneurysms. OBJECTIVE: To elucidate the effect of stents on radiologic outcomes and to analyze the risk factors for aneurysmal recanalization via propensity score matching. METHODS: From the 735 aneurysms treated with coil embolization with stents (n = 187) and without stents (n = 548) between 2009 and 2011, 157 propensity score-matched case pairs were selected. The recanalization rates and relevant risk factors were analyzed. The mean follow-up interval was 24.1 ± 11.3 months (range, 6-48 months) and 22.9 ± 11.4 months (range, 6-56 months) in the stent and nonstent groups, respectively (P = .388). RESULTS: The stent group demonstrated lower recanalization rates than the nonstent group during both the 6-month (1.9% vs 10.2%, P = .004) and the final follow-up periods (8.3% vs 18.5%, P = .005). The multivariate analysis identified the following significant factors for recanalization: the use of stents (hazard ratio, 0.40; 95% confidence interval, 0.21-0.76, P = .005), larger aneurysm size (hazard ratio, 1.21; 95% confidence interval, 1.11-1.31, P &lt; .001), and initially incomplete occlusion (hazard ratio, 2.39; 95% confidence interval, 1.28-4.43, P = .006). The incidence of permanent neurological complication tended to be higher in the stent group than in the nonstent group (3.2% vs 0%, P = .063). CONCLUSION: In this propensity score-matched analysis, stent implantation reduced the overall recanalization of the coiled cerebral aneurysms. However, the use of stents should be carefully decided upon.

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