Diagnosis and management of intracranial aneurysm rupture during endovascular embolization

Objective To study the causes, diagnosis, management and prognosis of aneurysm rupture during endovascular embolization. Methods The records of 420 patients with intracranial aneurysm received endovascular embolization during May 1994-June 2002 were retrospectively analyzed. Among these patients 15 cases of aneurysm rupture occurred during embolizing treatment (caused by penetration of catheter 3 cases, coil Scases, high pressure injection 1 case, unknown reason 3 cases). Immediate deepening anesthesia was performed after definite diagnosis of aneurysm rupture by cerebrovascular angiography. Then treatment with rapid completion of densely embolizing the aneurysm, and reversing heparinization with protamine, or extra-ventricular drainage and evacuation of intracranial hematoma were performed. Results Of these 15 cases with aneurysm, 11 cases with good recovery, 1 case sustaining permanent neurological deficit and 3 cases died were resulted after treatment. Conclusion Intracranial aneurysm rupture is the life-threatening complication during endovascular coil embolization and mainly relates to the aneurysm structural and morphological features. Less clinical experience may be one of the factors resuted in aneurysm rupture during operation. Prognosis of these patients depends on preoperative health status, the extent of bleeding, and appropriate treatment without delay.