Article Figures & Data
Figures
- Fig 1.
A 61-year-old woman presented with a Hunt and Hess scale grade 3 subarachnoid hemorrhage. Nonenhanced CT (not shown) showed a diffuse, nonlocalized, subarachnoid hemorrhage in the entire basal cistern. 3D reconstruction images of cerebral angiography reveal 3 similar-sized small aneurysms at the left superior cerebellar artery origin (A) and bilateral posterior communicating artery origin (B and C). Each of the 3 aneurysms also has an irregular shape with a daughter sac. The white arrowhead indicates a left tuberothalamic artery incorporated into the aneurysm sac. Postembolization control angiograms after balloon-assisted coiling for all 3 aneurysms show complete occlusion of the superior cerebellar artery (D) and the left posterior communicating artery (E) aneurysms, and an intentional neck remnant, from which a left tuberothalamic artery (black arrowhead) directly originated, of the right posterior communicating artery aneurysm (F).
Tables
Characteristics of patients and aneurysms, and immediate clinical and angiographic outcomes after treatment with 1-stage coilinga
Characteristics and Outcomes No. of patients (No. of aneurysms coiled) 167 (359) Age (yr) (mean) (range) 57.7 ± 10.6 (30–83) Male/female 30:137 Presentation with subarachnoid hemorrhage 35 (21.0%) No. of aneurysms per patient (range) 2.5 ± 0.9 (2–7) No. of coiled aneurysms per patient (range) 2.1 ± 0.4 (2–3) No. of patients with all detected aneurysms coiled 131 (78.4%) Location of aneurysms coiled (n = 359) ICA paraclinoid 135 (37.6%) ICA–posterior communicating artery 56 (15.6%) ICA–anterior choroidal artery 26 (7.2%) ICA bifurcation 7 (1.9%) Middle cerebral artery 58 (16.2%) Anterior cerebral artery 44 (12.3%) Vertebrobasilar artery 32 (8.9%) Aneurysm size (mm) (mean) (range) 5.6 ± 2.7 (2–21) <10 mm 326 (90.8%) 10–24.9 mm 33 (9.2%) Neck size (mm) (mean) (range) 3.3 ± 1.3 (0.4–10.0) Wide neck (neck size ≥4 mm or dome-to-neck ratio <1.5) 233 (64.9%) Distribution of aneurysms coiled Unilateral anterior circulation 73 (43.7%) Bilateral anterior circulation 66 (39.5%) Posterior circulation 3 (1.8%) Unilateral anterior + posterior circulation 20 (12.0%) Bilateral anterior + posterior circulation 5 (3.0%) Treatment-related morbidity (n = 167) 3 (1.8%; 95% CI, 0.24–3.83%) Treatment-related mortality (n = 167) 1 (0.6%; 95% CI, 0.58–1.78%) Immediate angiographic outcome Complete occlusion 186 (51.8%) Neck remnant 134 (37.3%) Sac remnant 33 (9.2%) Coiling failure 6 (1.7%) ↵a Data are shown as number (%) except where otherwise noted.
