Rupture of intracranial aneurysms during treatment with Guglielmi detachable coils: incidence, outcome, and risk factors

Object. The aim of this study was to assess the incidence and outcome of pr ocedure-related rupture of intracranial aneurysms in patients treated with Guglielmi detachable coils (GDCs) and to identify risk factors for this com plication. Methods. Procedure-related rupture occurred in seven of 264 treated aneurys ms in 239 consecutive patients. Aneurysm size, history of previous subarach noid hemorrhage (SAH) caused by the treated aneurysm, timing of treatment a fter SAH, and the use of a temporary occlusion balloon in the seven procedu res in which rupture occurred were compared with the remaining 257 procedur es, and these findings were correlated with data from 13 studies in the lit erature, in which results of 2030 aneurysm treatments were reported. Conclusions. Procedure-related rupture of intracranial aneurysms during GDC treatment occurs in 2.5% of cases and is responsible for 1% of treatment-r elated deaths. Risk factors are as follows: small aneurysm size, previous S AH, and probably the use of a temporary occlusion balloon.