Ischemic and hemorrhagic complications in coil embolization

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  • Wakui Daisuke
    The Department of Neurosurgery, St. Marianna University, School of Medicine
  • Ito Hidemichi
    The Department of Neurosurgery, St. Marianna University, School of Medicine
  • Onodera Hidetaka
    The Department of Neurosurgery, St. Marianna University, School of Medicine, Yokohama City Seibu Hospital
  • Morishima Hiroyuki
    The Department of Neurosurgery, Kawasaki City Tama Hospital
  • Oshio Kotaro
    The Department of Neurosurgery, St. Marianna University, School of Medicine
  • Tanaka Yuichiro
    The Department of Neurosurgery, St. Marianna University, School of Medicine

Bibliographic Information

Other Title
  • 脳動脈瘤塞栓術における虚血性合併症と出血性合併症
  • ノウ ドウミャクリュウ ソクセンジュツ ニ オケル キョケツセイ ガッペイショウ ト シュッケツセイ ガッペイショウ
Published
2018
DOI
  • 10.24723/jsne.23.1_45
Publisher
Japan Society of Neurosurgical Emergency

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Description

<p>  In 228 aneurysm cases, we assessed the relation of ischemic and hemorrhagic complications with age, sex, location, size, ruptured vs. unruptured status, WFNS (World Federation of Neurological Surgeons Committee) grade of ruptured cases and use of neck plasty. Of these 228 cases, 10 had ischemic complications (4.3%) and six had hemorrhagic complications (2.6%). Cases with ischemic complications were significantly correlated with those involving neck plasty. However, no permanent complications were identified. All hemorrhagic complications occurred in cases with ruptured aneurysms. In two cases with hemorrhagic complications, bleeding occurred at the end of coil insertion and the bleeding was stopped with the dilation of the balloon alone, which resulted in good prognosis. Excluding these cases, hemorrhage‒complicated cases tended to have a serious prognosis. Administering argatroban and performing high‒quality endovascular surgery is important for reducing complications. Improvements are also required for reducing the ischemic complications caused by neck plasty. There may be a need to administer dual antiplatelet therapy or perform reinforced heparinization.</p>

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