INTRODUCTION: The aim of the present study was to determine whether intracranial aneurysms are distended after coil embolization and to evaluate the distensibility of ruptured aneurysms treated with endovascular coiling. METHODS: This was a prospective study of 20 consecutive patients with 22 aneurysms, who presented with a ruptured cerebral aneurysm and were treated with endovascular coiling of the aneurysm in a single institution. A diagnostic digital subtraction angiography (DSA) and a three-dimensional radiographic angiography (3DRA) were performed with bi-plane angiography equipment (Philips V5000) immediately before and after the embolization procedure to detect volume enlargement of the aneurysm after embolization, and the extent of the enlargement. A simulation study with steel spheres was carried out to study the possible error of over-estimation of the postembolization volume due to the beam-hardening artifact. RESULTS: There was no procedure-related rupture of the aneurysms. The percentage by volume of solid coil within the coil mass ranged from 15.78% to 82.01% in the present series. All aneurysms showed distension which ranged from 0.09% to 34.23%. The distensibility of the aneurysms was 34.23%. Error due to the beam-hardening artifact was negligible. CONCLUSION: Endoluminal packing of intracranial saccular aneurysms with embolization coils could cause a certain degree of distension in aneurysms treated with coil embolization, with the degree of distension up to 34.2%. Intracranial aneurysms were able to tolerate a certain degree of endoluminal distension without a risk of immediate rupture, even those that had ruptured recently.
INTRODUCTION: The aim of the present study was to determine whether intracranial aneurysms are distended after coil embolization and to evaluate the distensibility of ruptured aneurysms treated with endovascular coiling. METHODS: This was a prospective study of 20 consecutive patients with 22 aneurysms, who presented with a ruptured cerebral aneurysm and were treated with endovascular coiling of the aneurysm in a single institution. A diagnostic digital subtraction angiography (DSA) and a three-dimensional radiographic angiography (3DRA) were performed with bi-plane angiography equipment (Philips V5000) immediately before and after the embolization procedure to detect volume enlargement of the aneurysm after embolization, and the extent of the enlargement. A simulation study with steel spheres was carried out to study the possible error of over-estimation of the postembolization volume due to the beam-hardening artifact. RESULTS: There was no procedure-related rupture of the aneurysms. The percentage by volume of solid coil within the coil mass ranged from 15.78% to 82.01% in the present series. All aneurysms showed distension which ranged from 0.09% to 34.23%. The distensibility of the aneurysms was 34.23%. Error due to the beam-hardening artifact was negligible. CONCLUSION: Endoluminal packing of intracranial saccular aneurysms with embolization coils could cause a certain degree of distension in aneurysms treated with coil embolization, with the degree of distension up to 34.2%. Intracranial aneurysms were able to tolerate a certain degree of endoluminal distension without a risk of immediate rupture, even those that had ruptured recently.
Authors: S Claiborne Johnston; Randall T Higashida; Daniel L Barrow; Louis R Caplan; Jacques E Dion; George Hademenos; L Nelson Hopkins; Andrew Molyneux; Robert H Rosenwasser; Fernando Vinuela; Charles B Wilson Journal: Stroke Date: 2002-10 Impact factor: 7.914
Authors: David O Wiebers; J P Whisnant; J Huston; I Meissner; R D Brown; D G Piepgras; G S Forbes; K Thielen; D Nichols; W M O'Fallon; J Peacock; L Jaeger; N F Kassell; G L Kongable-Beckman; J C Torner Journal: Lancet Date: 2003-07-12 Impact factor: 79.321