Fig.1 & 2: Angiographic image of the left internal caroid artery injection shows an aneurysm of the left supraclinoid internal carotid artery. Fig.1 without subtraction, Fig.2 with.
Fig.3: Angiographic image after coil embolization (performed because the patient had SAH) reveals a coil within the aneursym.
Coil Embolization Complications
- Complicaton rate 8.6% to 18.6% (median 10.6%), lower than surgical clipping
- Common complications: thrombo-embolic events, perforation of aneurysm, parent artery obstruction, collapsed coil, coil malposition, and coil migration
- Less risks of death
- Higher rate of rebleeding (2.4% versus 1%) - why*
- Advantages vary depending on location of aneurysm, but coil embolization is beneficial for all sites
* Recurrence = refilling of thee neck, sac, dome of a successfully treated aneurysm
What to Choose?
- Not all aneurysms required coil embolization. This depends on size, anatomy and location of aneurysms.
- People at increased risk for craniotomy (>65 years, poor clinical status, comorbid conditions)
- Suitability depends on size, anatomy, location of aneurysms (in ophthalmic artery or basilar tip artery)
- Better perform craniotomy if
- >10 mm size
- > 4mm neck
Ontario Heath Technology Advisory Committee. Coil Embolization for intracrinal aneurysms.