J Cerebrovasc Endovasc Neurosurg.  2013 Sep;15(3):184-190. 10.7461/jcen.2013.15.3.184.

Single-session Coil Embolization of Multiple Intracranial Aneurysms

• Oh K
• Lim YC

• KMID: 1491437
• DOI: http://doi.org/10.7461/jcen.2013.15.3.184

Abstract

OBJECTIVE
There is no clear treatment strategy for the management of multiple intracranial aneurysms because of variable anatomical distribution, difficult identification of the aneurysm ruptured, and poor overall outcomes. The purpose of this study was to assess the efficacy and safety of single-session coil embolization for multiple intracranial aneurysms.
METHODS
Between September 2008 and December 2012, 209 aneurysms in 117 patients were treated at our institute. Twenty eight among the 117 patients had multiple aneurysms with a total of 71, and 60 of the 71 aneurysms underwent coil embolization in a single-session.
RESULTS
A total of 60 aneurysms were treated with a single-session coil embolization, of which the most frequent locations were in the posterior communicating artery, followed by the middle cerebral artery. Immediate post-embolization angiographies showed total occlusion in 49 (81.7%) aneurysms, remnant neck in 6 (10%), and body-filling in 5 (8.3%). Procedure-related complications had developed in 2 (3.3%) of the 60 embolized aneurysms: an asymptomatic thromboembolic event, and a partial coil protrusion without a subsequent thromboembolic complication.
CONCLUSION
With careful evaluation of individual aneurysm characteristics and configuration, multiple intracranial aneurysms previously thought to require multimodality therapy can be safely treated in a single-session coil embolization.

Keyword

Multiple aneurysms; Coil embolization; Single-session

MeSH Terms

Aneurysm
Angiography
Arteries
Humans
Intracranial Aneurysm
Middle Cerebral Artery
Neck

Figure

• 

  Fig. 1 (A) Computed tomogrphy scan demonstrates left frontal parenchymal hemorrhage, subarachnoid hemorrhage in the interhemispheric fissure, and intraventricular hemorrhage. (B and C) Left internal carotid angiogram shows a ruptured pericallosal aneurysm and an unruptured wide-neck aneurysm of the left middle cerebral artery bifurcation. (D) Right internal carotid angiogram shows a wide-neck aneurysm of the right middle cerebral artery bifurcation. (E,F and G) Angiogram obtained immediately after emboization shows occlusion of the aneurysms preserving the parent arteries. (H) One-year follow-up magnetic resonance angiography shows continued occlusion of aneurysms and wide patency of the parent arteries.

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