title: Thromboembolic event detected by diffusion weighted magnetic resonance imaging after coil embolization of cerebral aneurysms.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the occurrence rate of diffusion positive lesions (DPLs), and to assess the peri-procedural risk factors for the occurrence of DPLs in patients who underwent coil embolization of cerebral aneurysms.
  
  
  METHODS
  A total of 304 saccular aneurysms were embolized during a seven-year period from Jan 2007 to Dec 2013. Of these, postoperative diffusion-weighted images were obtained in 186 procedures. There were 100 ruptured aneurysm and 86 unruptured aneurysms. The coiling procedures were as follows: simple coiling in 96, balloon assisted coiling (BAC) in 39, and stent assisted coiling (SAC) in 51 aneurysms. Clinical, angiographic and procedural factors were analyzed in relation to the occurrence of DPLs.
  
  
  RESULTS
  Overall, DPLs were observed in 50.5%. In unruptured aneurysms, DPLs occurred in 23.5% of BAC, 41.9% of SAC and 57.7% of simple coiling (p = 0.08). Among ruptured aneurysms, DPLs occurred in 63.6% of BAC, 62.5% of SAC and 54.3% of simple coiling (p = 0.71). DPLs had a tendency to increase in ruptured aneurysms compared with unruptured aneurysms (57% vs. 43%, p = 0.077). Logistic regression analysis revealed that age > 55 years was the only independent risk factor for the occurrence of DPLs.
  
  
  CONCLUSIONS
  DPLs occured more frequently in ruptured aneurysm and at an older age. Although most DPLs are asymptomatic, careful manipulation of cerebral or extracerebral arteries using various endovascular devices is important to reducing the occurrence of DPLs. BAC appeared to reduce occurrence of TE events in patient with unruptured aneurysm.
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Dong-Ho
authors.initials: DH
authors.lastname: Seo
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Seok-Mann
authors.identifier: 0000-0002-0048-9309
authors.initials: SM
authors.lastname: Yoon
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Hye-Ran
authors.initials: HR
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Jai-Joon
authors.initials: JJ
authors.lastname: Shim
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Hack-Gun
authors.initials: HG
authors.lastname: Bae
authors.affiliation: Department of Neurosurgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
authors.forename: Il-Gyu
authors.initials: IG
authors.lastname: Yun
keywords: Aneurysm; Balloon assisted coiling; Diffusion positive lesions; Embolization; Thromboembolism