Does endoluminal coil embolization cause distension of intracranial aneurysms?
BACKGROUND
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.


CONCLUSIONS
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.
Yu
Simon C H
SC
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, NT Hong Kong, People's Republic of China. simonyu@cuhk.edu.hk
Wong
Wilbur C K
WC
Chung
Albert C S
AC
Lee
Kwok-Tung
KT
Wong
George K C
GK
Poon
Wai S
WS
D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D015901:Angiography, Digital Subtraction; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000503:physiopathology; D004621:Embolization, Therapeutic / Q000295:instrumentation*; D006801:Humans; D021621:Imaging, Three-Dimensional; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D015641:Radiography, Interventional