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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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2/2020
vol. 15
 
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abstract:
Original paper

Thromboembolism during coiling of intracranial aneurysms: predictors and clinical outcome

Damian Kocur
1
,
Piotr Paździora
1
,
Nikodem Przybyłko
1
,
Wojciech Kukier
1
,
Jan Baron
2
,
Adam Rudnik
1

  1. Department of Neurosurgery, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
  2. Department of Radiology and Nuclear Medicine, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland
Videosurgery Miniinv 2020; 15 (2): 319–328
DOI: https://doi.org/10.5114/wiitm.2019.89118
Online publish date: 2019/10/17
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Introduction
Thromboembolism is one of the most serious complications associated with coil embolization therapy.

Aim
To identify predisposing factors for thromboembolic complications, as well as to determine whether thromboembolism has an impact on clinical outcome.

Material and methods
From February 2008 to March 2015, 273 consecutive patients were treated at our institution via endovascular coil embolization. Patient medical records were reviewed with an emphasis on procedure description, potential risk factors and clinical outcomes related to thromboembolism. Thromboembolic incidents occurred in 19 (6.9%) cases. Multivariate logistic regression models were used to determine independent predictors of thromboembolism. Clinical outcome was analyzed using the Glasgow Outcome Scale (GOS).

Results
Multivariate analysis showed that subarachnoid hemorrhage was an independent risk factor for thromboembolic complications (p = 0.003; OR = 4.4; 95% CI: 1.67–12.02). The difference in frequency of perioperative mortality (GOS 1) in patients with thromboembolism and without thromboembolism was not statistically significant (p = 0.22). The differences in frequencies of severe disability (GOS 2–3) and moderate to low disability (GOS 4–5) between patients with thromboembolism and without thromboembolism were statistically significant in the general study population (p < 0.05).

Conclusions
Subarachnoid hemorrhage is an independent predictor of thromboembolic complications associated with endovascular coiling of cerebral aneurysms. Thromboembolism is associated with significantly increased risk of morbidity, and it affects to a certain extent the periprocedural mortality.

keywords:

complications, embolization, endovascular aneurysm repair
  
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