Navigating Challenges in Neurointervention: Intra-Procedural Diagnosis and Tactical Management of Complications

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Introduction: Intracranial aneurysms present a significant challenge in neurovascular disorders, often requiring endovascular coiling as a primary treatment option. However, this procedure is marred by complications such as intraprocedural ruptures (IPR), thromboembolic events and arterial dissections, significantly impacting patient outcomes. Objective: This study aims to navigate the complexities of neurointerventional procedures and elucidate how intraprocedural diagnosis and management of complications influence long-term patient outcomes. Methods: Conducting a retrospective analysis of four cases involving intracranial aneurysm coiling procedures complicated by IPRs, thromboembolic events, flow diverter complications and carotid artery dissections. Each case is meticulously examined to underscore the importance of intraprocedural diagnosis and describe management approaches for these complications. Results: Our analysis unveils a spectrum of intraprocedural complications encountered during neurointerventional procedures, emphasising the prevalence and clinical significance of IPRs, thromboembolic events, flow diverter-related issues and arterial dissections. Effective management strategies, including pharmacological interventions, mechanical thrombectomy and adjunctive therapies such as coil embolisation and stent placement, are discussed comprehensively. Conclusion: Early detection, precise operator control and prompt intervention are pivotal in mitigating intraprocedural complications associated with intracranial aneurysm coiling. By delineating effective management strategies, this research aims to optimise patient outcomes and minimise procedural risks in neurointerventional practice. Implementing these strategies can lead to enhanced patient care and better overall prognosis for individuals undergoing endovascular treatment for intracranial aneurysms. This study underscores the importance of continuous refinement in neurointerventional techniques to optimise patient safety and treatment efficacy in managing intracranial aneurysms.