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. 2018 Dec 18:9:1125.
doi: 10.3389/fneur.2018.01125. eCollection 2018.

Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms

Sang-Hwa Lee  1 , Min Uk Jang  2 , Jihoon Kang  3 , Yeo Jin Kim  1 , Chulho Kim  1 , Jong-Hee Sohn  1 , Jinseo Yang  4 , Jin Pyeong Jeon  4 , Yongjun Cho  4 , Hyuk Jai Choi  4
Affiliations

Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms

Sang-Hwa Lee et al. Front Neurol. .

Abstract

Background: There is still controversy regarding which procedure-related factors affect the occurrence of periprocedural thromboembolism. This study aimed to investigate which procedure-related risk factors can be modified to prevent adverse thromboembolic events after coil embolization of intracranial aneurysm. Methods: Using a single-center database, we retrospectively identified a consecutive series of patients with symptomatic and asymptomatic cerebral aneurysms treated with coil embolization. We evaluated the following procedure-related factors: procedure time, procedure methods (simple coiling, stent-assisted coiling, and use of multiple microcatheters), and number of coils inserted. The primary outcome was the development of thromboembolism before and after coil embolization confirmed by diffusion-weighted imaging (DWI) irrespective of the location of the procedure. Pearson's chi-square, Student's t-test, multivariable logistic regression analysis, and sensitivity analysis with multinomial logistic regression analysis were used in the statistical analyses. Results: Of 180 cases enrolled, 146 (81.1%) had evidences of thromboembolism confirmed by DWI, and 13 (7.2%) had neurologic symptoms. Among the documented modifiable procedure-related factors, every 10 min increase in the procedure time was independently associated with the risk of thromboembolism, after adjusting the analysis (adjusted odds ratio 1.11; 95% confidence interval 1.01-1.21). The coiling methods, use of multiple catheters, and number of coils inserted did not change the effect of the procedure time on thromboembolic events (p for interactions > 0.05). Conclusion: This study showed that the procedure time might be the most effective modifiable factor for reducing thromboembolic events irrespective of the procedure methods used during coil embolization of cerebral aneurysms.

Keywords: cerebral aneurysm; coil embolization; procedure time; procedure-related factors; thromboembolism.

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