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Review
. 2018 Jun;24(3):237-245.
doi: 10.1177/1591019918758493. Epub 2018 Feb 21.

Complications of endovascular treatment for intracranial aneurysms: Management and prevention

Yon Kwon Ihn  1 , Shang Hun Shin  2 , Seung Kug Baik  3 , In Sup Choi  4
Affiliations
Review

Complications of endovascular treatment for intracranial aneurysms: Management and prevention

Yon Kwon Ihn et al. Interv Neuroradiol. 2018 Jun.

Abstract

Endovascular coiling for intracranial aneurysms has become an accepted treatment with good clinical results and provides adequate protection against rebleeding and rupture of aneurysms. However, despite the experience, preparation, or skill of the physician, complications during endovascular treatment still occur. The main complications of endovascular coiling are: procedural aneurysmal perforations by the microcatheter, micro-guidewire, or coil, and thromboembolic events. Such situations are unexpected, complex, and can have devastating consequences. In this article, we present a comprehensive review of the two most common complications, aneurysmal perforation and thromboembolism during endovascular coiling, and how we can prevent or overcome these complications to achieve a satisfactory outcome. In addition, as the flow diverter has been become an important tool for management of large, wide necked, and other anatomically challenging aneurysms, we also describe complications stemming from the use of the tool, which remains a novel treatment option for complex aneurysms.

Keywords: Aneurysm; complication; endovascular coiling; intraprocedural rupture; thromboembolic event.

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Figures

Figure 1.
Figure 1.
Example of workflow algorithm in the situation of intraprocedural aneurysm ruptures (IARs) during coiling. BP: blood pressure; CT: computed tomography.
Figure 2.
Figure 2.
Modified preventive antiplatelet preparation for coiling of unruptured aneurysm according to platelet function test.
See this image and copyright information in PMC

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