Most coil-induced aneurysmal ruptures during endovascular treatment occur in small, recently ruptured aneurysms, and after placement of at least one coil. In cases where the distal part of the microcatheter cannot move back due to its straightness and tightness, the last coil deployed may advance towards the aneurysmal wall through intercircles of deposited coils. To solve this problem, after complete occlusion of the sac is obtained, the microcatheter is slightly withdrawn until the tip of the catheter is placed in the neck, and then the neck is occluded with the appropriate coil.
CognardCWeillA: Intracranial berry aneurysms: angiographic and clinical results after endovascular treatment. Radiology206: 499–510, 1998.
2.
ViñuelaFDuckwilerGMawadM: Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients. J Neurosurg86: 474–482, 1997.
3.
BrilstraEHRinkelGJE: Treatment of intracranial aneurysms by embolization with coils: A systematic review. Stroke30: 470–476, 1999.
4.
SluzewskiMBoschJA: Rupture of intracranial aneurysms during treatment with Guglielmi detachable coils: incidence, outcome, and risk factors. J Neurosurg94: 238–240, 2001.
5.
LevyEKoebbeCJ: Rupture of intracranial aneurysms during endovascular coiling: management and outcomes. Neurosurgery49: 807–811; discussion 811–813, 2001.
6.
McDougallCGHalbachVV: Causes and management of aneurysmal haemorrhage occurring during embolization with Guglielmi detachable coils. J Neurosurg89: 87–92, 1998.
7.
RicolfiFLe GuerinelC: Rupture during treatment of recently ruptured aneurysms with Guglielmi electrodetachable coils. Am J Neuroradiol19: 1653–1658, 1998.
8.
DoerflerAWankeI: Aneurysmal rupture during Guglielmi detachable coils: causes, management, and outcome. Am J Neuroradiol22: 1825–1832, 2001.
9.
ShortJGMarxWF: Surgical salvage of microcatheter-induced aneurysm perforation during coil embolization. Am J Neuroradiol23: 682–685, 2002.
10.
GuglielmiGViñuelaF: Electrothrombosis of saccular aneurysms via endovascular approach. Part I: Electrochemical basis, technique, and experimental results. J Neurosurg75: 1–7, 1991.
11.
HayakawaMMurayamaY: Natural history of the neck remnant of a cerebral aneurysm treated with the Guglielmi detachable coil system. J Neurosurg93: 561–568, 2000.
12.
ByrneJVSohnMJ: Five-year experience in using coil embolization for ruptured intracranial aneurysm: Outcomes, and incidence of late rebleeding. J Neurosurg90: 656–663, 1999.
