Complications in intracranial aneurysm embolization with controllable coils

Objective[WT5”BZ] To explore the causes of countermeasures to the accidents in intracranial aneurysm embolization with controllable coils (mechanical detachable spiral, MDS, and/or Guglielmi detachable coil, GDC). [WT5”HZ]Methods[WT5”BZ] From March 1995 to July 1999, 120 patients with intracranial aneurysm (125 aneurysms) were embolized with controllable coils. 25 accidents including aneurysm bleeding, thrombosis or occlusion, and coil end protruding to the parent artery of aneurysm,which occurred in 22 patients (23 aneurysms) during treatment were reviewed. [WT5”HZ]Results[WT5”BZ] Among the 25 accidents, concomitant and secondary, there were 9 aneurysm ruptures,7 over embolizations, 7 coil end protrudings to the parent artery,and 2 thromboses. The accidents resulted in 4 deaths (3 33%,4/120), 2 permanent neurological deficits (1 67%), and 4 transitory neurological deficits (3 33%). The accidents were related to tho embolizing technique,tho pattern of aneurysm and its parent artery,the observation and management during embolization, and the limitation of coils. [WT5”HZ]Conclusions[WT5”BZ] Skilled emboli zing technique,better understanding of aneurysm and its parent artery angioanatomy,correct judgment during treatment and improved embolic material are helpful to reduce the accidents and the their effect.