title: Rupture of aneurysms in the immediate post-coiling period.
abstract: OBJECTIVE
  We present a series of cases featuring re-rupture of posterior communicating artery aneurysms in the immediate post-coiling period, where clots obscured the neck of the aneurysm during the procedure. We report on the incidence of re-rupture and discuss possible mechanisms behind this phenomenon.
  
  
  METHODS
  This study included 462 aneurysms over a 10-year period which were treated with endovascular coiling. 137 of these were ruptured aneurysms. Radiographic and clinical information pertaining to the patients was collected. The immediate post-coiling period was defined as ≤3 days following the procedure.
  
  
  RESULTS
  The incidence of re-rupture in the immediate post-coiling period was 1.4% (2/137). Of these two, one received recombinant tissue plasminogen activator and both received acetylsalicylic acid. One patient presented with adjacent hematoma on re-rupture. In both cases, clot obscured the aneurysm neck during the procedure.
  
  
  CONCLUSIONS
  Re-rupture of intracranial aneurysms in the immediate post-coiling period is an exceedingly rare complication, and the events leading to it have not been discussed at length. Repeat treatment, follow-up imaging and close observation are merited in the setting of re-rupture of a posterior communicating artery aneurysm.
authors.affiliation: Dalhousie University, Halifax, Canada.
authors.forename: Adam Andrew
authors.initials: AA
authors.lastname: Dmytriw
authors.forename: Gwynedd Elaine
authors.initials: GE
authors.lastname: Pickett
authors.forename: Jai J S
authors.initials: JJ
authors.lastname: Shankar
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000175:diagnosis* / Q000209:etiology; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis* / Q000601:surgery*; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome
keywords: Aneurysm; Coil; Complication; Hemorrhage; Thrombolysis