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E-011 Rupture of Aneurysms in the Immediate Post-Coiling Period
  1. A Dmytriw1,
  2. G Pickett2,
  3. J Shankar3
  1. 1Dalhousie Medical School, Halifax, NS, Canada
  2. 2Department of Neurosurgery, QEII Health Sciences Centre, Halifax, NS, Canada
  3. 3Department of Radiology, Division of Neuroradiology, QEII Health Sciences Centre, Halifax, NS, Canada


Purpose We present a series of cases featuring re-rupture of posterior communicating aneurysm in the immediate post-coiling period, wherein clots obscured the neck of the aneurysm during the procedure. We report on the incidence of re-rupture, and discuss possible mechanisms behind this phenomenon.

Methods This study included 462 aneurysms over a 10-year period, which were treated with endovascular coiling. 137 of these were ruptured aneurysms. Radiographic and clinical information pertaining to the patients was collected. The immediate post-coiling period was defined as three days or fewer following the procedure.

Results The incidence of re-rupture in the immediate post-coiling period was 1.4% (2 in 137). Of these two, one received rtPA and both received ASA. One patient presented with adjacent haematoma on re-rupture. In both cases, clot obscured the aneurysm neck during the procedure.

Conclusion Re-rupture of intracranial aneurysms in the immediate post-coiling period is an exceedingly rare complication, and the events leading to it have not been discussed at any length. Repeat treatment, follow-up imaging and close observation are merited in the setting of re-rupture of a posterior communicating aneurysm.

Disclosures A. Dmytriw: None. G. Pickett: None. J. Shankar: None.


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