Related factors and treatment of intraoperative rupture during embolization of intracranial aneurysms

Objective To study the causes, emergency managements and preventative measures of intraoperative rupture during embolization of intracranial aneurysms. Methods One hundred and thirty-two patients with intracranial aneurysms and having performed embolization were enrolled. Intraoperative rupture occurred in 6 patients during embolization of intracranial aneurysms. The causes were analyzed and emergency managements were reviewed. Results The causes were as follows: intracranial aneurysms were punctured by microtubular in 2 patients, by spring coil in 1 patient and by guidewire in 1 patient, and intracranial aneurysms were attributed to stent break in 1 patient and blood pressure fluctuation in 1 patient. The rapid embolization were performed, 1 patient underwent craniotomy evacuation of hematoma, 1 patient underwent lateral ventricular drainage, 2 patients underwent lumbar cistern drainage, and 2 patients did not receive any processing. At the discharge from hospital, 2 patients recovered well, 1 patient showed mild paralysis, 1 patient had severe disability, and 2 patients died. Conclusions Intraoperative rupture during embolization of intracranial aneurysms is the life-threatening complication and mainly relates to operation, structure of aneurysm, blood pressure fluctuation during operation. The prognosis depends on the extent of bleeding and appropriate treatment without delay. Key words: Intracranial aneurysm; Aneurysm, rupture; Endovascular therapy