ENDOVASCULAR TREATMENT OF RUPTURED POSTERIOR CIRCULATION ANEURYSMS USING ELECTROLYTICALLY DETACHABLE COILS

The authors report their experience using electrolytically detachable coils for the treatment of ruptured posterior circulation aneurysms. T wenty-six patients with 28 posterior circulation aneurysms were treate d. All patients were referred for endovascular treatment by experience d vascular neurosurgeons. Patients underwent follow-up angiography imm ediately after treatment. 1 to 6 weeks posttreatment, and 6 months pos ttreatment. Six-month follow-up angiograms obtained in 19 patients wit h 20 aneurysms demonstrated that 18 (90%) of the 20 aneurysms were 99 to 100% occluded, one aneurysm (5%) was approximately 90% occluded, an d one aneurysm (5%) was approximately 75% occluded. The patient with t he aneurysm that was approximately 75% occluded needed additional trea tment, consisting of parent artery balloon occlusion. and was consider ed a treatment failure (3.8% of patients). There was one treatment-ass ociated mortality (3.8%) but no treatment associated serious neurologi cal or nonneurological morbidity in the patient group. There was no re current aneurysm rupture during treatment or during the mean 27-month follow-up period. Endovascular treatment of ruptured posterior circula tion aneurysms with electrolytically detachable coils can be accomplis hed with low morbidity and mortality rates. The primary goal of treatm ent-preventing recurrent aneurysm-can be achieved over the short term. Endovascular coil occlusion will play an important role in the treatm ent of ruptured posterior circulation aneurysms, particularly if long- term efficacy in preventing recurrent aneurysm hemorrhage can be docum ented.