• Peizhuo Zang, Chuansheng Liang, Qiang Shi, and Yunjie Wang.
• Department of Neurosurgery, The First Affiliated Hospital of China Medical University, Shenyang, China. pzzang@mail.cmu.edu.cn
• Neurol India. 2011 May 1; 59 (3): 369-72.

BackgroundIntraprocedural aneurysm rupture is considered to be one of the most formidable complications of the endovascular treatment of cerebral aneurysms and is associated with high mortality.ObjectiveTo report the clinical outcomes of cerebral aneurysms that ruptured during endovascular coiling.Patients And MethodsOver a period of six years, 559 endovascular embolizations were performed in 467 patients, with 507 cerebral aneurysms. Intraprocedural aneurysm rupture occurred in 14 cases (mean aneurysm size, 3.8 mm). Follow-up angiograms, at a minimum of three months post embolization, were available in 11 living patients. Acute and follow-up results were reviewed.ResultsThe difference in the rates of aneurysm perforation during endovascular coiling between ruptured and unruptured aneurysms was significant (P < 0.05). There were three (21.4%) deaths related to this complication and three (21.4%) patients developed new deficits (modified Rankin Scale scores 1 to 2). Acute results of embolization were: complete occlusion in eight (57.1%), neck remnant in two (14.3%), and incomplete occlusion in four (28.6%) patients. Long-term follow-up results in 11 living patients were: major recanalization in one (9.1%), minor recanalization in one (9.1%), and stable occlusion in nine (81.8%).ConclusionIntraprocedural aneurysm rupture frequently occurs in small aneurysms and appears to be associated with relatively high rates of mortality.

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