title: Rate and clinical impact of intra-procedural complications during coil embolisation of ruptured small (3 mm or less) cerebral aneurysms.
abstract: OBJECTIVE
  Coiling of small (≤3 mm) cerebral aneurysms can be technically challenging and is associated with increased procedural-related morbidity and mortality. The authors report the clinical and radiological results following coiling of ruptured small cerebral aneurysms in a single-institution, and define the rates of intra-procedural rupture and thromboembolism.
  
  
  METHODS
  A retrospective analysis was conducted on consecutive patients from 01/01/2008 to 31/12/2010 with subarachnoid haemorrhage (SAH) from ruptured cerebral aneurysms (≤3 mm) managed in a tertiary neurosurgical institution in the United Kingdom.
  
  
  RESULTS
  Of the 108 patients identified, 72 patients (66.7%) underwent coil embolisation. A favourable outcome, defined as a Glasgow outcome score of 4-5, was achieved in 63 (87.5%) of these patients. Intra-procedural complications were observed in 11.1% (±7.3% 95% CI) of cases, wherein the rate of intra-procedural rupture was determined to be 8.3% (±6.4% 95% CI) and intra-procedural thromboembolism to be 2.8% (±3.8% 95% CI).
  
  
  CONCLUSIONS
  Although coil embolisation of small ruptured cerebral aneurysms is technically feasible and an efficacious means of treatment, it is associated with an increased rate of intra-procedural complications. This should be taken into account when embarking upon treatment of patients with ruptured small cerebral aneurysms.
authors: Department of Neurosurgery, Greater Manchester Neurosciences Centre, Salford Royal Foundation Trust, Salford M6 8HD, United Kingdom. carlos.chung@srft.nhs.uk
authors: K H Carlos
authors: KH
authors: Chung
authors: Amit
authors: A
authors: Herwadkar
authors: Roger
authors: R
authors: Laitt
authors: Hiren C
authors: HC
authors: Patel
mesh_terms: D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D002533:Cerebral Angiography; D016208:Databases, Factual; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D023261:Glasgow Outcome Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D011446:Prospective Studies; D012189:Retrospective Studies; D012306:Risk; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000209:etiology / Q000628:therapy
keywords: Cerebral aneurysm; Embolisation; Rate; Rupture; Small; Subarachnoid haemorrhage; Thromboembolism