E-011 Rupture of Aneurysms in the Immediate Post-Coiling Period

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We present a series of cases featuring re-rupture of posterior communicating aneurysm in the immediate post-coiling period, wherein clots obscured the neck of the aneurysm during the procedure. We report on the incidence of re-rupture, and discuss possible mechanisms behind this phenomenon.


This study included 462 aneurysms over a 10-year period, which were treated with endovascular coiling. 137 of these were ruptured aneurysms. Radiographic and clinical information pertaining to the patients was collected. The immediate post-coiling period was defined as three days or fewer following the procedure.


The incidence of re-rupture in the immediate post-coiling period was 1.4% (2 in 137). Of these two, one received rtPA and both received ASA. One patient presented with adjacent haematoma on re-rupture. In both cases, clot obscured the aneurysm neck during the procedure.


Re-rupture of intracranial aneurysms in the immediate post-coiling period is an exceedingly rare complication, and the events leading to it have not been discussed at any length. Repeat treatment, follow-up imaging and close observation are merited in the setting of re-rupture of a posterior communicating aneurysm.


A. Dmytriw: None. G. Pickett: None. J. Shankar: None.

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