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Original research
Factors related to adverse events during endovascular coil embolization for ruptured cerebral aneurysms
  1. Hirotoshi Imamura1,
  2. Nobuyuki Sakai1,
  3. Tetsu Satow2,
  4. Koji Iihara3
  5. JR-NET3 Study Group
    1. 1Neurosurgery, Kobe City Medical Center General Hospital, Kobe-city, Hyogo, Japan
    2. 2Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
    3. 3Neurosurgery, Kyushu University Faculty of Medicine Graduate School of Medical Sciences, Fukuoka, Japan
    1. Correspondence to Dr Hirotoshi Imamura, Neurosurgery, Kobe City Medical Center General Hospital, Kobe-city 6500047, Japan; i-hiro{at}zg7.so-net.ne.jp

    Abstract

    Background and purpose The risk factors for adverse events for example, intraprocedural rupture (IPR), ischemic complication within 24 hours, and rebleeding after endovascular coil embolization for a ruptured cerebral aneurysm remain unclear. The aim of this study was to identify significant associated risk factors.

    Methods We retrospectively evaluated data from 5358 patients listed on the Japanese Registry of Neuroendovascular Therapy 3 during 2010–2014.

    Results IPR, ischemic complications, and rebleeding occurred during or after 221 (4.1%), 226 (4.2%), and 63 (1.2%) treatments, respectively. All of the adverse events were significantly associated with the patients’ poor outcomes at 30 days. Multivariate analysis revealed the factors independently related to these adverse events as follows: (1) for IPR: female sex, bifurcation type, <5 mm aneurysm, emergent surgery, local anesthesia, a balloon-assisted technique; (2) for an ischemic complication: poor World Federation World Federation of Neurological Societies (WFNS) grade, wide neck, and stent-assisted technique; (3) for rebleeding: poor WFNS grade, bifurcation type, wide neck, and body filling as the initial result.

    Conclusions Knowledge of the risk factors of endovascular coil embolization and paying attention to them are essential for patients’ safe treatment and good outcomes.

    • aneurysm
    • coil
    • subarachnoid
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    Footnotes

    • Collaborators JR-NET3 Study Group: Co-principal investigators: Nobuyuki Sakai, Kobe City Medical Center General Hospital, Kobe, Japan; Koji Iihara, Kyushu University, Fukuoka, Japan; Tetsu Satow, National Cerebral and Cardiovascular Center, Suita, Japan. Investigators: Masayuki Ezura, Sendai Medical Center, Sendai, Japan; Akio Hyodo, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan; Shigeru Miyachi, Aichi Medical University, Aichi, Japan; Susumu Miyamoto, Kyoto University, Kyoto, Japan; Yoji Nagai, Kobe University, Kobe, Japan; Kunihiro Nishimura, National Cerebral and Cardiovascular Center, Suita, Japan; Kazunori Toyoda, National Cerebral and Cardiovascular Center, Suita, Japan. Co-investigators: Toshiyuki Fujinaka, Osaka Medical Center, Osaka, Japan; Toshio Higashi, Fukuoka University, Fukuoka, Japan; Masaru Hirohata, Kurume University, Kurume, Japan; Akira Ishii, Kyoto University, Kyoto, Japan; Hirotoshi Imamura, Kobe City Medical Center General Hospital, Kobe, Japan; Yasushi Ito, Shinrakuen Hospital, Niigata, Japan; Naoya Kuwayama, Toyama University, Toyama, Japan; Hidenori Oishi, Juntendo University, Tokyo, Japan; Yuji Matsumaru, Tsukuba University, Tsukuba, Japan; Yasushi Matsumoto, Konan Hospital, Sendai, Japan; Ichiro Nakahara, Fujita Medical University, Aichi, Japan; Chiaki Sakai, Hyogo College of Medicine, Nishinomiya, Japan; Kenji Sugiu, Okayama University, Okayama, Japan; Tomoaki Terada, Showa University Fujigaoka Hospital, Kanagawa, Japan; Shinichi Yoshimura, Hyogo College of Medicine, Nishinomiya, Japan; and Certified Specialists of Japanese Society of Neuroendovascular Therapy.

    • Contributors HI contributed to analysis, interpretation of data, and preparation of the manuscript. All other authors reviewed it, and approved the final version, and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding This study was supported in part by a Grant-in-Aid (Junkanki-Kaihatsu H24-4-3) from the National Cerebral and Cardiovascular Center, Japan and by Hatazaki Foundation, Kobe, Japan.

    • Competing interests HI received Speakers’ Bureau/Honoraria from Medtronic Co. NS received Speakers’ Bureau/Honoraria from Otsuka Pharmaceutical Co, Stryker Co, Medtronic Co, Medico’s Hirata Co, and Biomedical Solutions Co, and research funding from Otsuka Pharmaceutical Co, Terumo Co, and Daiichi Sankyo Co. KI received Speakers’ Bureau/Honoraria from Otsuka Pharmaceutical Co, and research funding from Otsuka Pharmaceutical Co, Mitsubishi Tanabe Pharma Co, Kaneka Medix Co, Chugai Pharmaceutical Co, and Eizai Co.

    • Patient consent for publication Not required.

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

    • Data availability statement Data are available in a public, open access repository.

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