Complications of endovascular treatment of cerebral aneurysms

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• 作者：Emanuele Orr¨´ ; Luca Roccatagliata ; Giacomo Cester ; Francesco Causin ; Lucio Castellan
• 关键词：Endovascular procedures ; Complications ; Aneurysms ; Cerebral vasculopathy ; Angiography ; Perforation ; Thrombo-embolism
• 刊名：European Journal of Radiology
• 出版年：2013
• 出版时间：October, 2013
• 年：2013
• 卷：82
• 期：10
• 页码：1653-1658
• 全文大小：1374 K

文摘

The number of neuroendovascular treatments of both ruptured and unruptured aneurysms has increased substantially in the last two decades. Complications of endovascular treatments of cerebral aneurysms are rare but can potentially lead to acute worsening of the neurological status, to new neurological deficits or death. Some of the possible complications, such as vascular access site complications or systemic side effects associated with contrast medium (e.g. contrast medium allergy, contrast induced nephropathy) can also be encountered in diagnostic angiography. The most common complications of endovascular treatment of cerebral aneurysms are related to acute thromboembolic events and perforation of the aneurysm. Overall, the reported rate of thromboembolic complications ranges between 4.7 % and 12.5 % while the rate of intraprocedural rupture of cerebral aneurysms is about 0.7 % in patients with unruptured aneurysms and about 4.1 % in patients with previously ruptured aneurysms.

Thromboembolic and hemorrhagic complications may occur during different phases of endovascular procedures and are related to different technical, clinical and anatomic reasons. A thorough knowledge of the different aspects of these complications can reduce the risk of their occurrence and minimize their clinical sequelae. A deep understanding of complications and of their management is thus part of the best standard of care.