Analysis of risk factors for perifocal oedema after endovascular embolization of unruptured intracranial arterial aneurysms

Open access


Background. Endovascular embolization is a treatment of choice for the management of unruptured intracranial aneurysms, but sometimes is complicated with perianeurysmal oedema. The aim of our study was to establish incidence and outcomes of perianeurysmal oedema after endovascular coiling of unruptured intracranial aneurysms, and to reveal possible risk factors for development of this potentially serious complication.

Methods. In total 119 adult patients with endovascular embolization of unruptured intracranial aneurysm (performed at Department for Interventional Neuroradiology, Clinical Center, Kragujevac, Serbia) were included in our study. The embolizations were made by electrolite-detachable platinum coils: pure platinum, hydrophilic and combination of platinum and hydrophilic coils. Primary outcome variable was perianeurysmal oedema visualized by magnetic resonance imaging (MRI) 7, 30 and 90 days after the embolization.

Results. The perianurysmal oedema appeared in 47.6% of patients treated with hydrophilic coils, in 21.6% of patients treated with platinum coils, and in 53.8% of those treated with mixed type of the coils. The multivariate logistic regression showed that variables associated with occurrence of perianeurysmal oedema are volume of the aneurysm, hypertension, diabetes and smoking habit. Hypertension is the most important independent predictor of the perianeurysmal oedema, followed by smoking and diabetes.

Conclusions. The results of our study suggest that older patients with larger unruptured intracranial aneurysms, who suffer from diabetes mellitus and hypertension, and have the smoking habit, are under much higher risk of having perianeurysmal oedema after endovascular coiling.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Pickett GE Laitt RD Herwadkar A Hughes DG. Visual pathway compromise after hydrocoil treatment of large ophthalmic aneurysms. Neurosurgery 2007; 61: E873-4.

  • 2. Schmidt GW Oster SF Golnik KC Tumialán LM Biousse V Turbin R et al. Isolated progressive visual loss after coiling of paraclinoid aneurysms. Am J Neuroradiol 2007; 28: 1882-9.

  • 3. Fanning NF Willinsky RA Brugge KG. Wall enhancement edema and hydrocephalus after endovascular coil occlusion of intradural cerebral aneurysms. J Neurosurg 2008; 108: 1074-86.

  • 4. Cohen JE Itshayek E Attia M Moscovici S. Postembolization perianeurysmal edema as a cause of uncinate seizures. J Clin Neurosci 2012; 19: 474-6.

  • 5. Vu Dang L Aggour M Thiriaux A Kadziolka K Pierot L. Post-embolization perianeurysmal edema revealed by temporal lobe epilepsy in a case of un-ruptured internal carotid artery aneurysm treated with bare platinum coils. J Neuroradiol 2009; 36: 298-300.

  • 6. Horie N Kitagawa N Morikawa M Tsutsumi K Kaminogo M Nagata I. Progressive perianeurysmal edema induced after endovascular coil embolization. Report of three cases and review of the literature. J Neurosurg 2007; 106: 916-20.

  • 7. Stracke CP Krings T Möller-Hartmann W Mahdavi A Klug N. Severe inflammatory reaction of the optic system after endovascular treatment of a supraophthalmic aneurysm with bioactive coils. Am J Neuroradiol 2007; 28: 1401-2.

  • 8. White JB Cloft HJ Kallmes DF. But did you use HydroCoil? Perianeurysmal edema and hydrocephalus with bare platinum coils. Am J Neuroradiol 2008; 29: 299-300.

  • 9. Craven I Patel UJ Gibson A Coley SC. Symptomatic perianeurysmal edema following bare platinum embolization of a small unruptured cerebral aneurysm. Am J Neuroradiol 2009; 30: 1998-2000.

  • 10. Killer M Hauser T Wenger A Richling B Ladurner G. Comparison of experimental aneurysms embolized with second-generation embolic devices and platinum coils. Acta Neurochir (Wien) 2009; 151: 497-505.

  • 11. Nishino K Ito Y Hasegawa H Shimbo J Kikuchi B Fujii Y. Development of cranial nerve palsy shortly after endosaccular embolization for asymptomatic cerebral aneurysm: report of two cases and literature review. Acta Neurochir (Wien) 2009; 151: 379-83.

  • 12. Im SH Han MH Kwon BJ Jung C Kim JE Han DH. Aseptic meningitis after embolization of cerebral aneurysms using hydrogel-coated coils: report of three cases. Am J Neuroradiol 2007; 28: 511-2.

  • 13. Killer M Arthur A Al-Schameri AR Barr J Elbert D Ladurner G et al. Cytokine and growth factor concentration in cerebrospinal fluid from patients with hydrocephalus following endovascular embolization of un-ruptured aneurysms in comparison with other types of hydrocephalus. Neurochem Res 2010; 35: 1652-8.

  • 14. Hayashi K Kitagawa N Morikawa M Horie N Kawakubo J Hiu T et al. Long-term follow-up of endovascular coil embolization for cerebral aneurysms using three-dimensional time-of-flight magnetic resonance angiography. Neurol Res 2009; 31: 674-80.

  • 15. Tomokiyo M Kazekawa K Onizuka M Aikawa H Tsutsumi M Ikoh M et al. Mechanisms of perianeurysmal edema following endovascular embolization of aneurysms. Interv Neuroradiol 2007; 13(Suppl 1): 145-50.

  • 16. Del Cañizo Gómez FJ Fernández Pérez C Moreno Ruiz I de Gorospe Pérez-Jáuregui C Silveira Rodríguez B González Losada T et al. Microvascular complications and risk factors in patients with type 2 diabetes. Endocrinol Nutr 2011; 58: 163-8.

  • 17. Mancini M Di Donato O Saldalamacchia G Liuzzi R Rivellese A Salvatore M. Contrast-enhanced ultrasound evaluation of peripheral microcirculation in diabetic patients: effects of cigarette smoking. Radiol Med 2013; 118: 206-14.

  • 18. Im SH Han MH Kwon BJ Jung C Kim JE Han DH. A meningitis after embolization of cerebral aneurysms using hydrogelcoated coils: report of three cases. Am J Neuroradiol 2007; 28: 511-2.

  • 19. Fanning NF Wilingsky RA Grugge KG. Wall enhancement edema and hydrocephalus after endovascular coil occlusion on intradural cerebral aneurysms. J Neurosurgery 2008; 108: 1074-86.

Journal information
Impact Factor

IMPACT FACTOR 2018: 1.846
5-year IMPACT FACTOR: 1.923

CiteScore 2018: 1.94

SCImago Journal Rank (SJR) 2018: 0.651
Source Normalized Impact per Paper (SNIP) 2018: 0.867

Cited By
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 316 82 6
PDF Downloads 118 50 3