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Early cease of intraaneurysmal contrast opacification during coil embolization in ruptured aneurysms compared with unruptured aneurysms.
MedLine Citation:
PMID:  21499153     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: The difference between coil-embolized ruptured and unruptured aneurysms with respect to intra-aneurysmal thrombus formation remains to be determined. OBJECTIVE:: We examined whether there was a difference between ruptured and unruptured coil-embolized aneurysms in the rate and timing of thrombus formation in the aneurysmal sac and discuss the effect of thrombus on the treatment outcome. METHODS:: We evaluated 209 aneurysms with an aneurysmal dome smaller than 10 mm and a neck size less than 4 mm. Of these, 91 (43.5%) were ruptured. We assessed intra-aneurysmal thrombus formation by the coil packing ratio (CPR): the percent coil volume occupying the aneurysmal sac. The initial CPR was defined as the CPR at which contrast influx into the sac ceased and the final CPR as that at the end of the procedure. ΔCPR was calculated as the difference between initial and final CPR. Embolized aneurysms were evaluated on follow-up angiographs. RESULTS:: The initial CPR was significantly lower in ruptured aneurysms (p < 0.01) and there was not a significant difference in the final CPR between ruptured and unruptured aneurysms (p = 0.05). ΔCPR was significantly higher in ruptured aneurysms (p < 0.01). The rate of aneurysmal recanalization was significantly higher in ruptured aneurysms (p < 0.05). The incidence of recanalization was high in ruptured aneurysms with low initial CPR- and ΔCPR values. CONCLUSION:: In ruptured aneurysms, intra-aneurysmal thrombus formation tends to occur in the earlier stages of coil embolization. In some cases thrombus formation may inhibit dense coil packing and result in recanalization.
Authors:
Masanori Tsutsumi; Hiroshi Aikawa; Kouhei Nii; Shuko Hamaguchi; Housei Etou; Kimiya Sakamoto; Hidenori Yoshida; Yoshihisa Matsumoto; Kiyoshi Kazekawa
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-4-14
Journal Detail:
Title:  Neurosurgery     Volume:  -     ISSN:  1524-4040     ISO Abbreviation:  -     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-4-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Neurosurgery and Neuroradiology, Fukuoka University Chikushi Hospital, 1-1-1 Zokumyoin, Chikushino, Fukuoka, 8188502, Japan.
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