Abstract
The risk factors of early hemorrhagic complications after endovascular coiling are not well-known. We identified the factors affecting early hemorrhagic complications, defined as any expansion or appearance of hemorrhage shown by head CT in the initial 48 hours after coiling. We retrospectively reviewed a series of 93 patients who underwent coiling for a ruptured saccular aneurysm between 2006 and 2012 at our hospital. Five patients showed early hemorrhagic complications, and all involved an expansion of the existing intracerebral hematoma immediately after coiling. The associated risk factors were accompanying intracerebral hemorrhage at onset (P < .001), postoperative antiplatelet therapy (P < .001), and thromboembolic complications (P = .044). In the accompanying intracerebral hemorrhage group, the associated risk factors were postoperative antiplatelet therapy (P = .044) and earlier initiation of coiling (9.8 ± 6.5 versus 28.1 ± 24.0 hours, P = .023). Early hemorrhagic complications were significant risk factors for worse clinical outcome (modified Rankin Scale, 2.02 ± 2.21 versus 4.4 ± 2.30, P = .022). None of the 93 patients showed further hemorrhage after the initial 48 hours after coiling. The accompanying intracerebral hemorrhage at onset, thromboembolic complications, postoperative antiplatelet therapy, and earlier initiation of coiling were the risk factors for early hemorrhagic complications.
Highlights
MethodsWe retrospectively reviewed a series of 93 patients who underwent coiling for a ruptured saccular aneurysm between 2006 and 2012 at our hospital
BACKGROUND AND PURPOSEThe risk factors of early hemorrhagic complications after endovascular coiling are not well-known
A recent guideline stated that endovascular coiling should be considered if ruptured aneurysms were judged to be technically amenable to both endovascular coiling and neurosurgical clipping.[1]
Summary
We retrospectively reviewed a series of 93 patients who underwent coiling for a ruptured saccular aneurysm between 2006 and 2012 at our hospital. We retrospectively reviewed a series of 93 patients who underwent coiling for a ruptured saccular aneurysm between September 2006 and March 2012 at our hospital. Patients for whom coiling was performed within 3 days of diagnosis were included. All patients presented with SAH confirmed by CT. Patients with accompanying intracerebral hematoma (ICH) other than SAH on preprocedural head CT were defined as having “accompanying ICH.”. The choice of clipping or coiling was determined by discussion with the neurosurgeons. If the patient had a large ICH with a widespread effect such as ICH with a poor World Federation of Neurosurgical Societies grade[4] of IV and V, clipping with evac-
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