Causes of bleeding during and after embolization of cerebral aneurysms

Abstract

Objective To investigate the causes of the hemorrage during and after embolization of cerebral aneurysms. Methods and Results We retrospectively analyzed 153 patients who underwent embolization of cerebral aneurysms from January 2015 to April 2017. Raymond Classification following initial treatment indicated 91 cases (59.48%) were in Raymond grade Ⅰ, 25 cases (16.34%) in Raymond grade Ⅱ, 37 cases (24.18% ) in Raymond grade Ⅲ. Wide ⁃ necked aneurysms were seen in 73 cases (47.71%). Stent assisted embolization was done in 63 cases (41.18%). Intraoperative bleeding rate was 1.31% (2/153), causes of bleeding were rupture after repeated over⁃selection of coil micro⁃catheter in place (one case), rupture of aneurysm when release of the first coil after stent opening (one case) and the 2 cases all died. Postoperative rebleeding rate was 1.31% (2/153), both patients were Raymond grade Ⅲ, one of them died after rebleeding, one with cerebral hematoma clearance and aneurysm clipping, the patient was followed up for one year in a stable condition. Conclusions Rupture of aneurysm wall by improper operation of micro⁃catheter or micro⁃guidewire during intracranial aneurysm embolization is the main cause of intraoperative bleeding, and Raymond Classification may be the influencing factor for rebleeding after embolization of cerebral aneurysms. DOI:10.3969/j.issn.1672⁃6731.2020.11.012

Keywords

• intracranial aneurysm
• embolization, therapeutic
• blood loss, surgical
• postoperative hemorrhage