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Year : 2020  |  Volume : 15  |  Issue : 3  |  Page : 594-600

Success rate of simple coil embolization in wide-neck aneurysm with aneurysmal shoulder

1 Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
2 Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University; Siriraj Center of Interventional Radiology, Siriraj Hospital, Bangkok, Thailand
3 Siriraj Center of Interventional Radiology, Siriraj Hospital; Department of Surgery, Neurosurgery Unit, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Correspondence Address:
Dr. Pattarawit Withayasuk
Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_248_20

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Background and Objective: Wide-necked intracranial aneurysm (WIA) is one of the challenging diseases for neuro-interventionist to treat by simple coiling technique. The purpose of this study is to identify the morphology associated with successful simple coil embolization in wide neck aneurysm patients. Materials and Methods: Between January 2002 and August 2018, 102 patients with total 115 ruptured or unruptured WIA which received endovascular treatment were retrospective reviewed. Data were analyzed including demographics, aneurysm morphology, endovascular technique, angiographic outcome, complication, regrowth, and retreatment rate. Results: The mean age of patients was 61.6 years with female predominant (72.5%). Ruptured WIA was diagnosed in 71 patients (61.7%). Majority of aneurysms were located in an anterior circulation which were 74 cases (64.3%), mainly paraclinoid aneurysm (30/115). Endovascular treatment was successful in 113 cases (98.3%) which can be mainly divided into simple coil embolization 50 cases (43.5%), balloon-assisted coil embolization 26 cases (22.6%), and stent-assisted coil embolization 32 cases (27.8%). Complete, subtotal, and incomplete occlusion of WIA was achieved in 32 cases (27.8%), 62 cases (53.9%), and 18 cases (15.7%), respectively. There was 9.6% complication occurred. Regrowth and retreatment were found 20% and 15.7%, respectively. Conclusion: WIA with two-sided aneurysmal shoulder or neck width <3.6 mm. are significantly associated with successful coil embolization using simple coiling technique.

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