Delayed rupture of a basilar artery aneurysm treated with coils: case report and review of the literature

J Neuroradiol. 2013 Mar;40(1):54-61. doi: 10.1016/j.neurad.2012.08.005. Epub 2013 Feb 18.


Delayed rupture of a previously unruptured cerebral aneurysm after uneventful saccular coil packing is rare, particularly when the quality of aneurysm occlusion is appropriate (neck remnant or total occlusion). The present report describes the case of a 70-year-old woman with an incidentally detected, asymptomatic, small basilar tip non-thrombosed aneurysm who experienced rupture of the aneurysm 2 years after coiling. Cerebral angiography taken on the day of rupture revealed only small recanalization of the aneurysm neck with no dome-filling. This is the first report of delayed rupture due to minor recurrence of a previously unruptured small asymptomatic cerebral aneurysm after saccular coil packing. A literature review of 26 reports of late bleeding after coil embolization of previously unruptured cerebral aneurysms showed that dome-filling after coil embolization, symptomatic aneurysms and large/giant aneurysms all increase the risk of delayed rupture in previously unruptured aneurysms after saccular coil packing.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aneurysm, Ruptured / diagnosis
  • Aneurysm, Ruptured / etiology*
  • Aneurysm, Ruptured / surgery*
  • Endovascular Procedures / adverse effects*
  • Endovascular Procedures / instrumentation*
  • Female
  • Humans
  • Intracranial Aneurysm / diagnosis*
  • Intracranial Aneurysm / surgery*
  • Magnetic Resonance Angiography / methods
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome