Hemorrhagic complications related to the stent-remodeled coil embolization of intracranial aneurysms

Dong Joon Kim, Sang Hyun Suh, Byungmoon Kim, Dong Ik Kim, Seung Kon Huh, Jae Whan Lee

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

OBJECTIVE: To evaluate the postprocedural hemorrhagic complications associated with stent-remodeled coil embolization of intracranial aneurysms. METHODS: From the database of 163 cases of stent-remodeled therapy for wide-neck intracranial aneurysms, patients who showed intracranial hemorrhagic complications on follow-up brain imaging were selected. The initial presentation, antithrombotic medication, hemorrhagic type, location, amount, association with ventriculostomy, symptomatic involvement, and outcome were assessed. RESULTS: Ten patients (6.1%) developed intracranial hemorrhagic complications (range; 0-422 days; mean; 56 days). The hemorrhagic complication rate was higher in patients with acute subarachnoid hemorrhage (20%, 6 of 30 patients) than in patients with unruptured aneurysms (3%, 4 of 133 patients). Nine of the 10 patients were on dual-antiplatelet therapy at the time of hemorrhage development. Seven of the hemorrhages developed in patients with ventriculostomies (intraparenchymal, n = 4; subdural hematoma, n = 3). Three patients who did not receive a ventriculostomy also developed intracranial hemorrhage (n = 1) or intraparenchymal hemorrhage (n = 2). Hemorrhagic transformation in the recently infarcted brain tissue seemed to be the cause of nonventriculostomy related intraparenchymal hemorrhage. The hemorrhages were accompanied by symptomatic aggravation in 6 of 10 cases, with 5 cases resulting in moribund clinical outcome. CONCLUSION: Postprocedural intracranial hemorrhage may be a risk of stent-remodeled therapy while the patient is on dual-antiplatelet medication. Extra caution is warranted especially in patients with acute subarachnoid hemorrhage requiring ventriculostomy or with underlying recent brain infarction.

Original languageEnglish
Pages (from-to)73-78
Number of pages6
JournalNeurosurgery
Volume67
Issue number1
DOIs
Publication statusPublished - 2010 Jul 1

Fingerprint

Intracranial Aneurysm
Stents
Ventriculostomy
Hemorrhage
Intracranial Hemorrhages
Subarachnoid Hemorrhage
Brain Infarction
Subdural Hematoma
Neuroimaging
Aneurysm
Neck
Therapeutics
Databases

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Surgery

Cite this

Kim, Dong Joon ; Suh, Sang Hyun ; Kim, Byungmoon ; Kim, Dong Ik ; Huh, Seung Kon ; Lee, Jae Whan. / Hemorrhagic complications related to the stent-remodeled coil embolization of intracranial aneurysms. In: Neurosurgery. 2010 ; Vol. 67, No. 1. pp. 73-78.
@article{4260f6b21d974206b14d2f8c3c2b43af,
title = "Hemorrhagic complications related to the stent-remodeled coil embolization of intracranial aneurysms",
abstract = "OBJECTIVE: To evaluate the postprocedural hemorrhagic complications associated with stent-remodeled coil embolization of intracranial aneurysms. METHODS: From the database of 163 cases of stent-remodeled therapy for wide-neck intracranial aneurysms, patients who showed intracranial hemorrhagic complications on follow-up brain imaging were selected. The initial presentation, antithrombotic medication, hemorrhagic type, location, amount, association with ventriculostomy, symptomatic involvement, and outcome were assessed. RESULTS: Ten patients (6.1{\%}) developed intracranial hemorrhagic complications (range; 0-422 days; mean; 56 days). The hemorrhagic complication rate was higher in patients with acute subarachnoid hemorrhage (20{\%}, 6 of 30 patients) than in patients with unruptured aneurysms (3{\%}, 4 of 133 patients). Nine of the 10 patients were on dual-antiplatelet therapy at the time of hemorrhage development. Seven of the hemorrhages developed in patients with ventriculostomies (intraparenchymal, n = 4; subdural hematoma, n = 3). Three patients who did not receive a ventriculostomy also developed intracranial hemorrhage (n = 1) or intraparenchymal hemorrhage (n = 2). Hemorrhagic transformation in the recently infarcted brain tissue seemed to be the cause of nonventriculostomy related intraparenchymal hemorrhage. The hemorrhages were accompanied by symptomatic aggravation in 6 of 10 cases, with 5 cases resulting in moribund clinical outcome. CONCLUSION: Postprocedural intracranial hemorrhage may be a risk of stent-remodeled therapy while the patient is on dual-antiplatelet medication. Extra caution is warranted especially in patients with acute subarachnoid hemorrhage requiring ventriculostomy or with underlying recent brain infarction.",
author = "Kim, {Dong Joon} and Suh, {Sang Hyun} and Byungmoon Kim and Kim, {Dong Ik} and Huh, {Seung Kon} and Lee, {Jae Whan}",
year = "2010",
month = "7",
day = "1",
doi = "10.1227/01.NEU.0000370937.70207.95",
language = "English",
volume = "67",
pages = "73--78",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

Hemorrhagic complications related to the stent-remodeled coil embolization of intracranial aneurysms. / Kim, Dong Joon; Suh, Sang Hyun; Kim, Byungmoon; Kim, Dong Ik; Huh, Seung Kon; Lee, Jae Whan.

In: Neurosurgery, Vol. 67, No. 1, 01.07.2010, p. 73-78.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Hemorrhagic complications related to the stent-remodeled coil embolization of intracranial aneurysms

AU - Kim, Dong Joon

AU - Suh, Sang Hyun

AU - Kim, Byungmoon

AU - Kim, Dong Ik

AU - Huh, Seung Kon

AU - Lee, Jae Whan

PY - 2010/7/1

Y1 - 2010/7/1

N2 - OBJECTIVE: To evaluate the postprocedural hemorrhagic complications associated with stent-remodeled coil embolization of intracranial aneurysms. METHODS: From the database of 163 cases of stent-remodeled therapy for wide-neck intracranial aneurysms, patients who showed intracranial hemorrhagic complications on follow-up brain imaging were selected. The initial presentation, antithrombotic medication, hemorrhagic type, location, amount, association with ventriculostomy, symptomatic involvement, and outcome were assessed. RESULTS: Ten patients (6.1%) developed intracranial hemorrhagic complications (range; 0-422 days; mean; 56 days). The hemorrhagic complication rate was higher in patients with acute subarachnoid hemorrhage (20%, 6 of 30 patients) than in patients with unruptured aneurysms (3%, 4 of 133 patients). Nine of the 10 patients were on dual-antiplatelet therapy at the time of hemorrhage development. Seven of the hemorrhages developed in patients with ventriculostomies (intraparenchymal, n = 4; subdural hematoma, n = 3). Three patients who did not receive a ventriculostomy also developed intracranial hemorrhage (n = 1) or intraparenchymal hemorrhage (n = 2). Hemorrhagic transformation in the recently infarcted brain tissue seemed to be the cause of nonventriculostomy related intraparenchymal hemorrhage. The hemorrhages were accompanied by symptomatic aggravation in 6 of 10 cases, with 5 cases resulting in moribund clinical outcome. CONCLUSION: Postprocedural intracranial hemorrhage may be a risk of stent-remodeled therapy while the patient is on dual-antiplatelet medication. Extra caution is warranted especially in patients with acute subarachnoid hemorrhage requiring ventriculostomy or with underlying recent brain infarction.

AB - OBJECTIVE: To evaluate the postprocedural hemorrhagic complications associated with stent-remodeled coil embolization of intracranial aneurysms. METHODS: From the database of 163 cases of stent-remodeled therapy for wide-neck intracranial aneurysms, patients who showed intracranial hemorrhagic complications on follow-up brain imaging were selected. The initial presentation, antithrombotic medication, hemorrhagic type, location, amount, association with ventriculostomy, symptomatic involvement, and outcome were assessed. RESULTS: Ten patients (6.1%) developed intracranial hemorrhagic complications (range; 0-422 days; mean; 56 days). The hemorrhagic complication rate was higher in patients with acute subarachnoid hemorrhage (20%, 6 of 30 patients) than in patients with unruptured aneurysms (3%, 4 of 133 patients). Nine of the 10 patients were on dual-antiplatelet therapy at the time of hemorrhage development. Seven of the hemorrhages developed in patients with ventriculostomies (intraparenchymal, n = 4; subdural hematoma, n = 3). Three patients who did not receive a ventriculostomy also developed intracranial hemorrhage (n = 1) or intraparenchymal hemorrhage (n = 2). Hemorrhagic transformation in the recently infarcted brain tissue seemed to be the cause of nonventriculostomy related intraparenchymal hemorrhage. The hemorrhages were accompanied by symptomatic aggravation in 6 of 10 cases, with 5 cases resulting in moribund clinical outcome. CONCLUSION: Postprocedural intracranial hemorrhage may be a risk of stent-remodeled therapy while the patient is on dual-antiplatelet medication. Extra caution is warranted especially in patients with acute subarachnoid hemorrhage requiring ventriculostomy or with underlying recent brain infarction.

UR - http://www.scopus.com/inward/record.url?scp=77954106382&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77954106382&partnerID=8YFLogxK

U2 - 10.1227/01.NEU.0000370937.70207.95

DO - 10.1227/01.NEU.0000370937.70207.95

M3 - Article

C2 - 20559093

AN - SCOPUS:77954106382

VL - 67

SP - 73

EP - 78

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

IS - 1

ER -