Endovascular coil embolization of very small intracranial aneurysms.
OBJECTIVE
We aimed to evaluate the results of endovascular coil embolization for very small aneurysms (<or= 3 mm).


METHODS
Between March 2005 and December 2008, a total of 31 very small aneurysms in 30 patients were treated by coil embolization. Of the 31 aneurysms, five (16%) were ruptured, as opposed to 26 (84%) that were not. We assessed the procedural complications, immediate angiographic outcome after coiling, clinical outcome, and follow-up MR angiography (MRA).


RESULTS
Two thromboembolic complications occurred during the procedure, but did not lead to any persistent neurologic deficit. No procedural aneurysmal rupture was observed and procedure-related morbidity and mortality were both 0%. Occlusion was adequate in 25 aneurysms (81%) and incomplete in six aneurysms (19%). The clinical outcomes of five patients with ruptured aneurysms were good (Glasgow outcome scale >or= 4), with no bleeding of the treated aneurysms during a mean follow-up period of 13.3 months. On 27 follow-up MRA, there was no recurrence, and the five incompletely occluded aneurysms showed a spontaneous amelioration resulting in an adequate occlusion.


CONCLUSIONS
Coil embolization of very small aneurysms is technically feasible with good results. The long-term efficacy and the potential as a standard treatment strategy remain to be determined by randomized large trials.
Chae
Kil Sung
KS
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jeon
Pyoung
P
Kim
Keon Ha
KH
Kim
Sung Tae
ST
Kim
Hyung Jin
HJ
Byun
Hong Sik
HS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000628:therapy*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000628:therapy*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
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