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Endovascular coil embolization of 435 small asymptomatic unruptured intracranial aneurysms: procedural morbidity and patient outcome Im SH; Han MH; Kwon OK; Kwon BJ; Kim SH; Kim JE; Oh CWAJNR Am J Neuroradiol 2009[Jan]; 30 (1): 79-84BACKGROUND AND PURPOSE: Whether treatment of small asymptomatic aneurysms is appropriate or not remains controversial. We performed a retrospective study on the procedural morbidity and mortality of coil embolization of small asymptomatic unruptured intracranial aneurysms (UIAs) to obtain a more generalized estimate of procedural risk. MATERIALS AND METHODS: A total of 435 small (maximum diameter < or = 7 mm) asymptomatic UIAs in 370 patients were treated by coil embolization. Aneurysm sizes were determined by using 3D angiograms. We assessed procedure-related morbidity and mortality, immediate postprocedural angiographic results, short-term imaging follow-up results, and clinical outcomes. RESULTS: Initial aneurysm occlusion was complete in 334 aneurysms, near complete in 78, and incomplete in 22. One internal carotid artery (ICA) aneurysm that ruptured during the procedure was treated with parent artery occlusion. Two hundred wide-neck aneurysms were coiled with the aid of various neck-remodeling techniques. The 44 procedure-related complications were the following: 24 thromboembolisms, 11 coil protrusions or prolapses into the parent vessel, 4 intraprocedural ruptures, 3 device-related complications, and 2 femoral-access complications. We had a total of 44 (10.1%) procedure-related complications with only 1 leading to persistent neurologic deficit. Procedure-related permanent morbidity and mortality were 0.27% (1/370) and 0%, respectively. CONCLUSIONS: In this series of small unruptured asymptomatic aneurysms, endovascular treatment was achieved with good short-term angiographic outcome and low permanent neurologic impairment. The goal of this study was not to provide a conclusion about treatment guidelines for small UIA but rather to help guide future recommendations by presenting a more generalized estimate of endovascular treatment risk than is currently available.|Adolescent[MESH]|Adult[MESH]|Aged[MESH]|Aged, 80 and over[MESH]|Aneurysm, Ruptured/mortality/therapy[MESH]|Balloon Occlusion/*instrumentation/*mortality[MESH]|Cerebral Angiography/statistics & numerical data[MESH]|Child[MESH]|Female[MESH]|Humans[MESH]|Intracranial Aneurysm/*mortality/*therapy[MESH]|Korea/epidemiology[MESH]|Male[MESH]|Middle Aged[MESH]|Prevalence[MESH]|Risk Assessment/*methods[MESH]|Risk Factors[MESH]|Survival Analysis[MESH]|Survival Rate[MESH]|Treatment Outcome[MESH]|Young Adult[MESH] |
