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Hemorrhagic stroke
Original research
Timing of complications during and after elective endovascular intracranial aneurysm coiling
  1. Michelle Masayo Kameda-Smith1,
  2. Paula Klurfan1,2,
  3. Brian Anthony van Adel1,2,3,
  4. Ramiro Larrazabal2,
  5. Forough Farrokhyar1,4,
  6. Michael Bennardo1,
  7. Thorsteinn Gunnarsson1,2
  1. 1 Division of Neurosurgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
  2. 2 Department of Radiology, McMaster University, Hamilton, Ontario, Canada
  3. 3 Division of Neurology, Department of Internal Medicine, McMaster University, Hamilton, Ontario, Canada
  4. 4 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
  1. Correspondence to Dr Thorsteinn Gunnarsson, Division of Neurosurgery, Hamilton General Hospital 237 Barton, St. E Hamilton, Ontario, L8L 2X2, Canada; thorsteinn.gunnarsson{at}gmail.com

Abstract

Objective To determine the time to complications during and after elective endovascular intracranial aneurysm coiling.

Methods A retrospective chart review of patients undergoing elective endovascular aneurysm coiling between March 2006 and October 2013 in one large Eastern Canadian Neurointerventional Service was performed. Data regarding the incidence, time and type of complication related to the endovascular coiling procedure and clinical outcome at last follow-up were collected. Patient, aneurysm and operation factors were analyzed to determine any factors associated with complication occurrence.

Results Of the 150 patient procedures analyzed, 16% experienced a coiling-related complication, although none resulted in death. 6.7% of patients experienced an intraoperative complication, of which thromboembolism was the most common type. The majority of the complications were detected in the first 6 hours after reversal of anesthesia, and a small proportion the next morning prior to discharge. Only 3.3% of patients had persistent neurological deficit after the procedure on last follow-up. Duration of the operation demonstrated a strong association with the occurrence of procedure-related complications.

Conclusion This study demonstrates that coiling-related complications of elective endovascular coiling tend to occur either intraoperatively or are detected shortly after reversal of anesthesia. Further investigation with a larger cohort may help to guide important preoperative communication with patients and identify a select group of patients who may not necessarily require prolonged admission to hospital for observation.

  • time to complication
  • unruptured intracranial aneurysm
  • coiling
  • day surgery
  • endovascular

https://doi.org/10.1136/neurintsurg-2017-013110

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    Footnotes

    • Contributors MMK-S, TG, PK, BAvA, RL and FF conceived and designed the study. MMK-S and MB were involved in the data acquisition. FF performed the data analysis and interpretation of data was performed by MMK-S, FF, TG, PK, BAvA, RL. The final draft was written by MMK-S. Draft revisions, approval and agreement to be accountable for all aspects of the work were reached by all the named authors.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Ethics approval Hamilton Integrated Research Ethics Board (HiREB).

    • Provenance and peer review Not commissioned; externally peer reviewed.