Abstract
Purpose: Endovascular coil embolization for very small aneurysms (≤3mm) is considered to be technically challenging because of technical difficulties and high complication rates. We aimed to evaluate the results of endovascular coil embolization for very small aneurysms.
Materials and Methods: Between 1998 and 2012, 48 very small aneurysms in 45 patients were treated with coil embolization. Twenty-seven aneurysms were ruptured, and 21 were unruptured. Of the 21 unruptured aneurysms, 8 were associated with ruptured aneurysm and 13 were detected incidentally by routine examination. We assessed the procedural complications, type of the first coil, total number and length of the coils used, initial angiographic results immediately after the procedure, and shortterm follow-up angiographic results.
Results: Two aneurysms ruptured during the procedure but did not lead to any neurological deficit. One thromboembolic complication occurred and led to hemiparesis. The procedure-related morbidity and mortality were 2.2% and 0%, respectively. Extrasoft and ultrasoft coils were mainly used for the first coil. The total number of the coils used ranged from 1 to 3 in 70% of the cases. The total length of the coil used was <10cm in 60% of the cases. Immediately after coil embolization, complete occlusion, neck remnant, and dome filling were achieved in 23 (50%), 8 (17%), and 16 aneurysms (33%), respectively. None of the cases had rerupture and retreatment from initial treatment to follow-up. Some incompletely occluded aneurysms spontaneously led to complete occlusion during the follow-up period.
Conclusion: Coil embolization of very small aneurysms is technically feasible. Appropriate selection of patients and careful consideration of the technical issues in the treatment of these aneurysms are essential to achieve technical success. A delicate procedure is required to prevent complications during the procedure.
