Safety and efficacy of endovascular treatment of ruptured tiny cerebral aneurysms compared with ruptured larger aneurysms.

PURPOSE: To investigate the effect and safety of endovascular embolization of tiny aneurysms (≤3 mm) within 72 h of subarachnoid hemorrhage compared with larger ones.

MATERIALS AND

METHODS

Patients with intracranial aneurysms treated with endovascular embolization within 72 h were retrospectively enrolled and divided into group A (n = 33) with ruptured tiny aneurysms (≤3 mm) and group B (n = 244) with ruptured larger aneurysms (>3 mm). The clinical and angiographic data before and after embolization were analyzed.

RESULTS

Most tiny aneurysms were located at the posterior communicating artery (36.4%) followed by anterior communicating artery (18.2%). The stent-assisted coiling technique was used mostly in group A with 18 stents deployed (51.5%), but only 24 (9.8%) patients had stent-assisted coiling in group B, with the stent-assisted coiling technique more significantly (P < 0.001) frequently used in group A. No significant (P > 0.05) difference existed in the total, subtotal and incomplete occlusion of aneurysms in two groups. The procedure-related complication rate was not significantly (P > 0.05) different between groups A (24.2%) and B (17.0%). At discharge, no significant (P > 0.05) difference existed in the neurological abnormality between the two groups. Follow-up was performed in 64.5% (20/31) in group A and 75.6% (177/234) in group B. No significant (P > 0.05) difference existed in the aneurysm recurrence rate, deaths, and prognosis.

CONCLUSION

Early embolization of tiny cerebral aneurysms within 72 h of subarachnoid hemorrhage is safe and effective compared with ruptured large aneurysms treated in the same manner.