Long-term Outcomes After Intraprocedural Aneurysm Rupture During Coil Embolization of Unruptured Intracranial Aneurysms

Keitaro Yamagami, Taketo Hatano, Ichiro Nakahara, Akira Ishii, Mitsushige Ando, Hideo Chihara, Takenori Ogura, Keita Suzuki, Daisuke Kondo, Takahiko Kamata, Eiji Higashi, Shota Sakai, Hiroki Sakamoto, Koji Iihara, Izumi Nagata

Research output: Contribution to journalArticle

Abstract

Background: The long-term outcomes of patients with intraprocedural aneurysm rupture (IPR) during endovascular coiling of unruptured intracranial aneurysms (UIAs) remain unclear. We investigated the long-term outcomes and predictors of neurological outcomes in patients who sustained IPR during coil embolization of UIAs. Methods: We retrospectively analyzed the medical record of 312 untreated UIAs in 284 patients who underwent endovascular coiling between April 2013 and July 2018. Results: The mean follow-up period for the entire cohort was 25.6 months. Twelve patients (3.8%) experienced IPR. The mean aneurysm size in the IPR cohort was significantly smaller than that in the no-IPR cohort (P = 0.045). The IPR cohort had a higher percentage of earlier subarachnoid hemorrhage from another aneurysm (P = 0.019), anterior communicating artery (AComA) aneurysm (P < 0.001), and basilar artery (BA) aneurysm (P = 0.022) than the no-IPR cohort. Neurologic deterioration was observed in 3 patients. The morbidity and mortality rates of the IPR cohort were 25% and 8.3%, respectively. Patients with IPR during coil embolization for AComA aneurysm did not develop neurological deterioration. Two of the 3 patients (66.7%) with a BA aneurysm had neurological deterioration. The proportion of patients with an mRS score of 0–2 at the last follow-up did not differ between the 2 cohorts (P = 0.608). Conclusions: The proportion of functionally independent patients did not differ between patients with and without IPR. Patients with BA aneurysms who developed an IPR tended to exhibit more unfavorable clinical courses than patients with AcomA aneurysms.

Original languageEnglish
JournalWorld Neurosurgery
DOIs
Publication statusAccepted/In press - Jan 1 2019

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Intracranial Aneurysm
Aneurysm
Rupture
Subarachnoid Hemorrhage
Nervous System
Medical Records

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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Long-term Outcomes After Intraprocedural Aneurysm Rupture During Coil Embolization of Unruptured Intracranial Aneurysms. / Yamagami, Keitaro; Hatano, Taketo; Nakahara, Ichiro; Ishii, Akira; Ando, Mitsushige; Chihara, Hideo; Ogura, Takenori; Suzuki, Keita; Kondo, Daisuke; Kamata, Takahiko; Higashi, Eiji; Sakai, Shota; Sakamoto, Hiroki; Iihara, Koji; Nagata, Izumi.

In: World Neurosurgery, 01.01.2019.

Research output: Contribution to journalArticle

Yamagami, K, Hatano, T, Nakahara, I, Ishii, A, Ando, M, Chihara, H, Ogura, T, Suzuki, K, Kondo, D, Kamata, T, Higashi, E, Sakai, S, Sakamoto, H, Iihara, K & Nagata, I 2019, 'Long-term Outcomes After Intraprocedural Aneurysm Rupture During Coil Embolization of Unruptured Intracranial Aneurysms', World Neurosurgery. https://doi.org/10.1016/j.wneu.2019.10.038
Yamagami, Keitaro ; Hatano, Taketo ; Nakahara, Ichiro ; Ishii, Akira ; Ando, Mitsushige ; Chihara, Hideo ; Ogura, Takenori ; Suzuki, Keita ; Kondo, Daisuke ; Kamata, Takahiko ; Higashi, Eiji ; Sakai, Shota ; Sakamoto, Hiroki ; Iihara, Koji ; Nagata, Izumi. / Long-term Outcomes After Intraprocedural Aneurysm Rupture During Coil Embolization of Unruptured Intracranial Aneurysms. In: World Neurosurgery. 2019.
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title = "Long-term Outcomes After Intraprocedural Aneurysm Rupture During Coil Embolization of Unruptured Intracranial Aneurysms",
abstract = "Background: The long-term outcomes of patients with intraprocedural aneurysm rupture (IPR) during endovascular coiling of unruptured intracranial aneurysms (UIAs) remain unclear. We investigated the long-term outcomes and predictors of neurological outcomes in patients who sustained IPR during coil embolization of UIAs. Methods: We retrospectively analyzed the medical record of 312 untreated UIAs in 284 patients who underwent endovascular coiling between April 2013 and July 2018. Results: The mean follow-up period for the entire cohort was 25.6 months. Twelve patients (3.8{\%}) experienced IPR. The mean aneurysm size in the IPR cohort was significantly smaller than that in the no-IPR cohort (P = 0.045). The IPR cohort had a higher percentage of earlier subarachnoid hemorrhage from another aneurysm (P = 0.019), anterior communicating artery (AComA) aneurysm (P < 0.001), and basilar artery (BA) aneurysm (P = 0.022) than the no-IPR cohort. Neurologic deterioration was observed in 3 patients. The morbidity and mortality rates of the IPR cohort were 25{\%} and 8.3{\%}, respectively. Patients with IPR during coil embolization for AComA aneurysm did not develop neurological deterioration. Two of the 3 patients (66.7{\%}) with a BA aneurysm had neurological deterioration. The proportion of patients with an mRS score of 0–2 at the last follow-up did not differ between the 2 cohorts (P = 0.608). Conclusions: The proportion of functionally independent patients did not differ between patients with and without IPR. Patients with BA aneurysms who developed an IPR tended to exhibit more unfavorable clinical courses than patients with AcomA aneurysms.",
author = "Keitaro Yamagami and Taketo Hatano and Ichiro Nakahara and Akira Ishii and Mitsushige Ando and Hideo Chihara and Takenori Ogura and Keita Suzuki and Daisuke Kondo and Takahiko Kamata and Eiji Higashi and Shota Sakai and Hiroki Sakamoto and Koji Iihara and Izumi Nagata",
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T1 - Long-term Outcomes After Intraprocedural Aneurysm Rupture During Coil Embolization of Unruptured Intracranial Aneurysms

AU - Yamagami, Keitaro

AU - Hatano, Taketo

AU - Nakahara, Ichiro

AU - Ishii, Akira

AU - Ando, Mitsushige

AU - Chihara, Hideo

AU - Ogura, Takenori

AU - Suzuki, Keita

AU - Kondo, Daisuke

AU - Kamata, Takahiko

AU - Higashi, Eiji

AU - Sakai, Shota

AU - Sakamoto, Hiroki

AU - Iihara, Koji

AU - Nagata, Izumi

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The long-term outcomes of patients with intraprocedural aneurysm rupture (IPR) during endovascular coiling of unruptured intracranial aneurysms (UIAs) remain unclear. We investigated the long-term outcomes and predictors of neurological outcomes in patients who sustained IPR during coil embolization of UIAs. Methods: We retrospectively analyzed the medical record of 312 untreated UIAs in 284 patients who underwent endovascular coiling between April 2013 and July 2018. Results: The mean follow-up period for the entire cohort was 25.6 months. Twelve patients (3.8%) experienced IPR. The mean aneurysm size in the IPR cohort was significantly smaller than that in the no-IPR cohort (P = 0.045). The IPR cohort had a higher percentage of earlier subarachnoid hemorrhage from another aneurysm (P = 0.019), anterior communicating artery (AComA) aneurysm (P < 0.001), and basilar artery (BA) aneurysm (P = 0.022) than the no-IPR cohort. Neurologic deterioration was observed in 3 patients. The morbidity and mortality rates of the IPR cohort were 25% and 8.3%, respectively. Patients with IPR during coil embolization for AComA aneurysm did not develop neurological deterioration. Two of the 3 patients (66.7%) with a BA aneurysm had neurological deterioration. The proportion of patients with an mRS score of 0–2 at the last follow-up did not differ between the 2 cohorts (P = 0.608). Conclusions: The proportion of functionally independent patients did not differ between patients with and without IPR. Patients with BA aneurysms who developed an IPR tended to exhibit more unfavorable clinical courses than patients with AcomA aneurysms.

AB - Background: The long-term outcomes of patients with intraprocedural aneurysm rupture (IPR) during endovascular coiling of unruptured intracranial aneurysms (UIAs) remain unclear. We investigated the long-term outcomes and predictors of neurological outcomes in patients who sustained IPR during coil embolization of UIAs. Methods: We retrospectively analyzed the medical record of 312 untreated UIAs in 284 patients who underwent endovascular coiling between April 2013 and July 2018. Results: The mean follow-up period for the entire cohort was 25.6 months. Twelve patients (3.8%) experienced IPR. The mean aneurysm size in the IPR cohort was significantly smaller than that in the no-IPR cohort (P = 0.045). The IPR cohort had a higher percentage of earlier subarachnoid hemorrhage from another aneurysm (P = 0.019), anterior communicating artery (AComA) aneurysm (P < 0.001), and basilar artery (BA) aneurysm (P = 0.022) than the no-IPR cohort. Neurologic deterioration was observed in 3 patients. The morbidity and mortality rates of the IPR cohort were 25% and 8.3%, respectively. Patients with IPR during coil embolization for AComA aneurysm did not develop neurological deterioration. Two of the 3 patients (66.7%) with a BA aneurysm had neurological deterioration. The proportion of patients with an mRS score of 0–2 at the last follow-up did not differ between the 2 cohorts (P = 0.608). Conclusions: The proportion of functionally independent patients did not differ between patients with and without IPR. Patients with BA aneurysms who developed an IPR tended to exhibit more unfavorable clinical courses than patients with AcomA aneurysms.

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