Clinical and Angiographic Follow-up of Ruptured Intracranial Aneurysms Treated with Endovascular Embolization

Article Figures & Data

Table 1:

Patient and aneurysm characteristics

	Number (%)
Mean age (years) ± SD	54.8 ± 15
Sex: male/female	119 (32)/258 (68)
Total number of aneurysms treated	391
Number of aneurysms treated per patient
1	364 (97)
2	12 (3.2)
3	1 (0.3)
Size of aneurysm treated
< 5 mm	131 (34)
5–15 mm	243 (62)
15–25 mm	15 (3.8)
> 25 mm	2 (0.5)

Table 2:

Aneurysm location (391 aneurysms in 377 patients)

Location	Number (%)
Anterior circulation	270 (69)
Anterior communicating artery	131 (34)
Posterior communicating artery	78 (20)
Parophthalmic artery	20 (5.1)
Middle cerebral artery	18 (4.6)
Carotid termination	10 (2.6)
Anterior choroidal artery	7 (1.8)
Anterior cerebral artery	2 (0.5)
Pericallosal artery	2 (0.5)
Ophthalmic artery	2 (0.5)
Posterior circulation	121 (31)
Basilar artery	85 (22)
Superior cerebellar artery	14 (3.4)
Posterior inferior cerebellar artery	12 (3.1)
Vertebral artery	5 (1.3)
Posterior cerebral artery	5 (1.3)

Table 4:

Neurologic outcome in patients with significant procedural complications

Table 6:

Data on patients with rehemorrhage after coil embolization (n = 8)

Age	Sex	Initial HH	Location of Treated Aneurysm	Size	Immediate Angiographic Result	Time to Rebleeding (Days)	Intervention	GOS
62	Male	4	BA	14 mm	Body remnant	3606	None	1^*
61	Male	1	VA	6.3 mm	Neck remnant	161	Recoiling	2^*
84	Female	2	MCA	3.0 mm	Complete occlusion	29	None	1
59	Male	4	AcomA	6.0 mm	Neck remnant	5	None	4
46	Female	1	MCA	6.5 mm	Body remnant	1	None	1
67	Female	2	AcomA	5.0 mm	Complete occlusion	1	None	1
42	Male	5	Pericallosal	5.3 mm	Neck remnant	1	Clipping	4^†
70	Female	3	AcomA	6.1 mm	Neck remnant	1	None	1

Note:—GOS indicates Glasgow Outcome Scale; HH, Hunt and Hess; BA, basilar artery; VA, vertebral artery; MCA, middle cerebral artery; AcomA, anterior communicating artery.
* Recanalization evident on post rehemorrhage angiography.
† Patient given intravenous abciximab.

Table 7:

Complication rates in Groups 1 and 2

	Group 1 (1994-June 2004)			Group 2 (June 2004-April 2008)
	No. of Patients	Total Patients	%	No. of Patients	Total Patients	%
Failed attempts	25	206	12.1	9	205	4.4
Intraprocedural complications
Aneurysm perforations	16	189	8.5	7	188	3.7
Thromboembolic events	16	189	8.5	6	188	3.2
Rehemorrhage	4	189	2.1	3	188	1.6
Recanalization	26	138	18.8	30	138	21.7

Table 8:

Long-term follow-up studies after coiling of ruptured intracranial aneurysms

Author	No. of Patients	Mean Follow-up Time in Months (Longest Follow-up)	Procedural Complications (Permanent Morbidity and Mortality)	Recanalization Rate	Rehemorrhage (Early/Late)
Present study, 2008	377	22.3 (120)	12% (2.9%)	20.3%	1.6%/0.5%
Aikawa, 2007²⁶	227	50.4 (NS)	NS	10%	NS/2.6%
Sluzewski, 2005²⁹	393	47.7 (120)	NS	NS	NS/1.27%
Friedman, 2003³⁹	83	19.1 (112)	19% (2%)	15%	0%/0%
Sluzewski, 2003³⁰	160	37.1 (72)	NS (3.8%)	25%	NS/1.2%
Kremer, 2002⁹	79	41 (74)	NS	NS	NS/3%
Byrne, 1999⁴	317	22.3 (65)	NS	14.7%	NS/1.6%