Coil Embolization of Intracranial Aneurysms: The Effectiveness and Limitation

ABSTRACT

This study was designed for the investigation of the effectiveness and limitation of the endovascular coil embolization of intracranial aneurysms. From July 1995 to October 1997, the authors treated 25 patients of intracranial aneurysm with endovascular coil embolization. There were 15 cases of ruptured aneurysms and 10 cases of unruptured aneurysms. The main reasons for the coil embolization were difficult anatomical location and poor neurological condition. Total 28 aneurysms were tried to embolize with coil. Among these, 12 aneurysms were occluded completely, 12 aneurysms partially, and 1 vertebral artery fusiform aneurysm was treated by coil occlusion of the proximal vertebral artery. The complete occlusion was possible in 10 cases of 15 small aneurysms(66.7%), and in 2 cases of 6 large aneurysms(33.3%). Only partial occlusion was achieved in all 3 giant aneurysms. Of 18 small neck aneurysms(4mm) could be occluded completely. There were 3 cases of failure, 2 cases being catherizatioin failure because of the tortuous vessel and 1 case due to local vasospasm. The complications related to the coil embolization were the perforation of the aneurysm caused by the catheterization in 2 cases, rebleeding after partial embolization of the aneurysm in 2 patients of Hunt-Hess grade 4 and 5, and infarction caused by parent vessel occlusion by coil protrusion in 2 cases. In conclusion, the coil embolization can be an alternative modality in the treatment of intracranial aneurysms. But the complete occlusion is not always possible in all cases, and the risk of the rebleeding is still remained in the partially occluded aneurysms. The long-term study is needed to confirm the definite effectiveness of the coil embolization in the treatment of intracranial aneurysms.