Short- and Intermediate-Term Angiographic and Clinical Outcomes of Patients with Various Grades of Coil Protrusions Following Embolization of Intracranial Aneurysms

Abdihalim, Mohamed; Kim, S. H.; Maud, Alberto; Suri, M. Fareed K.; Tariq, Nauman; Qureshi, Adnan I.

doi:10.3174/ajnr.a2572

Cited by 18 publications

(12 citation statements)

References 22 publications

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“…In some patients, such as those with large neck to dome ratio, stent assisted coil embolization was performed. Our protocol for coil embolization of intracranial aneurysms was previously described . Patients were re‐evaluated with 6‐ and 18‐month follow up angiograms, whenever possible, followed by studies performed at the discretion of the treating physician.…”

Section: Methodsmentioning

confidence: 99%

Are Coil Compaction and Aneurysmal Growth Two Distinct Etiologies Leading to Recurrence Following Endovascular Treatment of Intracranial Aneurysm?

Abdihalim

Watanabe

Chaudhry

et al. 2013

Journal of Neuroimaging

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Section: Methodsmentioning

confidence: 99%

Are Coil Compaction and Aneurysmal Growth Two Distinct Etiologies Leading to Recurrence Following Endovascular Treatment of Intracranial Aneurysm?

Abdihalim

Watanabe

Chaudhry

et al. 2013

Journal of Neuroimaging

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“…It is generally believed that protrusion of only a few loops does not pose an additional risk if appropriate antiplatelet therapy is used. 1 Alternatively, moderate to severe coil protrusion into the parent artery may necessitate coil retrieval or stent deployment in the parent artery. 2 However, there are few reports assessing the frequency of thrombo-embolic events, associated with various degrees of coil protrusion.…”

Section: Introductionmentioning

confidence: 99%

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

Ishihara

Niimi

et al. 2015

Interv Neuroradiol

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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.

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“…In the case of a clinically silent coil prolapse presented in the case of our database no interventional treatment was initiated. Because the blood flow in the parent artery was maintained we decided to treat the patient conservatively with aggressive antiplatelet therapy, as was presented in previous reports [35,36]. The clinical and radiographic course of our patient with 20-month follow-up proceeded uneventfully, suggesting that the expectant management is likely to be a safe treatment option for non-massive coil protrusions in small MCA aneurysms.…”

Section: Discussionmentioning

confidence: 66%

Endovascular treatment of small (< 5 mm) unruptured middle cerebral artery aneurysms

et al. 2019

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Purpose We report our experience with endovascular treatment of these lesions, with special consideration of angiographic and clinical outcomes and periprocedural complications. Material and methods The analysis included treatment results of 19 patients with 20 aneurysms. The aneurysm size ranged from 1.9 to 4.7 mm (mean 3.8, SD 0.7). Clinical examinations with the use of modified Rankin Score and angiographic outcomes were evaluated initially postembolisation and at a minimum follow-up of six months. Results Initial post-treatment complete and near-complete aneurysm occlusion was achieved in 19 (95%) cases and incomplete occlusion in one (5%) case. Imaging follow-up, performed in 17 (89.4%) patients, showed no change in the degree of occlusion in 16 (94.1%) patients and coil compaction in one (5.9%). There were no retreatment procedures. The procedure-related mortality rate was 5% (1/20) and was associated with intraprocedural aneurysm rupture. There was a case of a clinically silent coil prolapse into the parent artery. The clinical follow-up evaluation achieved in 17 (89.4%) patients showed no change in clinical status in all followed patients. Conclusions Endovascular treatment of small unruptured middle cerebral artery aneurysms is feasible and effective. The procedure-related complications are not negligible, especially in terms of the benign natural course of these lesions.

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Short- and Intermediate-Term Angiographic and Clinical Outcomes of Patients with Various Grades of Coil Protrusions Following Embolization of Intracranial Aneurysms

Cited by 18 publications

References 22 publications

Are Coil Compaction and Aneurysmal Growth Two Distinct Etiologies Leading to Recurrence Following Endovascular Treatment of Intracranial Aneurysm?

Are Coil Compaction and Aneurysmal Growth Two Distinct Etiologies Leading to Recurrence Following Endovascular Treatment of Intracranial Aneurysm?

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

Endovascular treatment of small (< 5 mm) unruptured middle cerebral artery aneurysms

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Short- and Intermediate-Term Angiographic and Clinical Outcomes of Patients with Various Grades of Coil Protrusions Following Embolization of Intracranial Aneurysms

Cited by 18 publications

References 22 publications

Are Coil Compaction and Aneurysmal Growth Two Distinct Etiologies Leading to Recurrence Following Endovascular Treatment of Intracranial Aneurysm?

Are Coil Compaction and Aneurysmal Growth Two Distinct Etiologies Leading to Recurrence Following Endovascular Treatment of Intracranial Aneurysm?

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

Endovascular treatment of small (&lt; 5 mm) unruptured middle cerebral artery aneurysms

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Endovascular treatment of small (< 5 mm) unruptured middle cerebral artery aneurysms