Endovascular treatment of ruptured intracranial aneurysms with detachable coils: long-term clinical and serial angiographic results

Radiology. 2003 Jun;227(3):720-4. doi: 10.1148/radiol.2273020656.


Purpose: To evaluate the stability of aneurysm occlusion over time, the need for additional treatments, and the long-term clinical outcome of patients, with emphasis on late recurrences of bleeding.

Materials and methods: The records of 160 patients with aneurysmal subarachnoid hemorrhage who were treated with coils were retrospectively reviewed. Follow-up angiography was performed 6 and 18 months after coil placement, and the results were classified as complete, near complete, and incomplete occlusion.

Results: Six (4%) of the 160 patients experienced procedural mortality or dependency. After a mean follow-up of 36 months, 134 (84%) patients had a good outcome. Outcome was independent of aneurysm size and location and timing of treatment. Reopening of the aneurysm occurred exclusively during the first 6 months after coil placement, mainly in aneurysms larger than 15 mm. Between 6 and 18 months, no change in aneurysm occlusion was observed. Additional coil placement was performed in 15 (9%) patients. After this second coil placement, nine (7%) aneurysms were still incompletely occluded. Additional therapy was performed in eight (5%) patients. Two recurrences of bleeding were observed in two incompletely occluded large aneurysms. No recurrences of bleeding occurred in patients with completely or near completely occluded aneurysms.

Conclusion: Coil placement is an effective and safe treatment strategy for patients with aneurysmal subarachnoid hemorrhage. If aneurysm occlusion is sufficient at 6 months, the yield of further follow-up angiography is very low.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / diagnostic imaging
  • Aneurysm, Ruptured / therapy*
  • Cerebral Angiography
  • Embolization, Therapeutic*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Aneurysm / complications
  • Intracranial Aneurysm / diagnostic imaging
  • Intracranial Aneurysm / therapy*
  • Male
  • Middle Aged
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Subarachnoid Hemorrhage / epidemiology
  • Subarachnoid Hemorrhage / etiology
  • Time Factors
  • Treatment Outcome