Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms

Background: There is still controversy regarding which procedure-related factors affect the occurrence of periprocedural thromboembolism. This study aimed to investigate which procedure-related risk factors can be modified to prevent adverse thromboembolic events after coil embolization of intracran...

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Main Authors: Sang-Hwa Lee, Min Uk Jang, Jihoon Kang, Yeo Jin Kim, Chulho Kim, Jong-Hee Sohn, Jinseo Yang, Jin Pyeong Jeon, Yongjun Cho, Hyuk Jai Choi
Format: Article
Language:English
Published: Frontiers Media S.A. 2018-12-01
Series:Frontiers in Neurology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fneur.2018.01125/full
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author Sang-Hwa Lee
Min Uk Jang
Jihoon Kang
Yeo Jin Kim
Chulho Kim
Jong-Hee Sohn
Jinseo Yang
Jin Pyeong Jeon
Yongjun Cho
Hyuk Jai Choi
author_facet Sang-Hwa Lee
Min Uk Jang
Jihoon Kang
Yeo Jin Kim
Chulho Kim
Jong-Hee Sohn
Jinseo Yang
Jin Pyeong Jeon
Yongjun Cho
Hyuk Jai Choi
author_sort Sang-Hwa Lee
collection DOAJ
description Background: There is still controversy regarding which procedure-related factors affect the occurrence of periprocedural thromboembolism. This study aimed to investigate which procedure-related risk factors can be modified to prevent adverse thromboembolic events after coil embolization of intracranial aneurysm.Methods: Using a single-center database, we retrospectively identified a consecutive series of patients with symptomatic and asymptomatic cerebral aneurysms treated with coil embolization. We evaluated the following procedure-related factors: procedure time, procedure methods (simple coiling, stent-assisted coiling, and use of multiple microcatheters), and number of coils inserted. The primary outcome was the development of thromboembolism before and after coil embolization confirmed by diffusion-weighted imaging (DWI) irrespective of the location of the procedure. Pearson's chi-square, Student's t-test, multivariable logistic regression analysis, and sensitivity analysis with multinomial logistic regression analysis were used in the statistical analyses.Results: Of 180 cases enrolled, 146 (81.1%) had evidences of thromboembolism confirmed by DWI, and 13 (7.2%) had neurologic symptoms. Among the documented modifiable procedure-related factors, every 10 min increase in the procedure time was independently associated with the risk of thromboembolism, after adjusting the analysis (adjusted odds ratio 1.11; 95% confidence interval 1.01–1.21). The coiling methods, use of multiple catheters, and number of coils inserted did not change the effect of the procedure time on thromboembolic events (p for interactions > 0.05).Conclusion: This study showed that the procedure time might be the most effective modifiable factor for reducing thromboembolic events irrespective of the procedure methods used during coil embolization of cerebral aneurysms.
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spelling doaj.art-a77684d8c71a424b93e1d988055c75162022-12-22T01:32:39ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-12-01910.3389/fneur.2018.01125418974Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral AneurysmsSang-Hwa Lee0Min Uk Jang1Jihoon Kang2Yeo Jin Kim3Chulho Kim4Jong-Hee Sohn5Jinseo Yang6Jin Pyeong Jeon7Yongjun Cho8Hyuk Jai Choi9Department of Neurology, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South KoreaDepartment of Neurology, Hallym University College of Medicine, Dongtan Sacred Heart Hospital, Hwaseong, South KoreaDepartment of Neurology, Seoul National University Bundang Hospital, Seoul National University, Seongnam, South KoreaDepartment of Neurology, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South KoreaDepartment of Neurology, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South KoreaDepartment of Neurology, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South KoreaDepartment of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South KoreaDepartment of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South KoreaDepartment of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South KoreaDepartment of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, South KoreaBackground: There is still controversy regarding which procedure-related factors affect the occurrence of periprocedural thromboembolism. This study aimed to investigate which procedure-related risk factors can be modified to prevent adverse thromboembolic events after coil embolization of intracranial aneurysm.Methods: Using a single-center database, we retrospectively identified a consecutive series of patients with symptomatic and asymptomatic cerebral aneurysms treated with coil embolization. We evaluated the following procedure-related factors: procedure time, procedure methods (simple coiling, stent-assisted coiling, and use of multiple microcatheters), and number of coils inserted. The primary outcome was the development of thromboembolism before and after coil embolization confirmed by diffusion-weighted imaging (DWI) irrespective of the location of the procedure. Pearson's chi-square, Student's t-test, multivariable logistic regression analysis, and sensitivity analysis with multinomial logistic regression analysis were used in the statistical analyses.Results: Of 180 cases enrolled, 146 (81.1%) had evidences of thromboembolism confirmed by DWI, and 13 (7.2%) had neurologic symptoms. Among the documented modifiable procedure-related factors, every 10 min increase in the procedure time was independently associated with the risk of thromboembolism, after adjusting the analysis (adjusted odds ratio 1.11; 95% confidence interval 1.01–1.21). The coiling methods, use of multiple catheters, and number of coils inserted did not change the effect of the procedure time on thromboembolic events (p for interactions > 0.05).Conclusion: This study showed that the procedure time might be the most effective modifiable factor for reducing thromboembolic events irrespective of the procedure methods used during coil embolization of cerebral aneurysms.https://www.frontiersin.org/article/10.3389/fneur.2018.01125/fullthromboembolismcoil embolizationcerebral aneurysmprocedure-related factorsprocedure time
spellingShingle Sang-Hwa Lee
Min Uk Jang
Jihoon Kang
Yeo Jin Kim
Chulho Kim
Jong-Hee Sohn
Jinseo Yang
Jin Pyeong Jeon
Yongjun Cho
Hyuk Jai Choi
Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms
Frontiers in Neurology
thromboembolism
coil embolization
cerebral aneurysm
procedure-related factors
procedure time
title Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms
title_full Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms
title_fullStr Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms
title_full_unstemmed Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms
title_short Impact of Reducing the Procedure Time on Thromboembolism After Coil Embolization of Cerebral Aneurysms
title_sort impact of reducing the procedure time on thromboembolism after coil embolization of cerebral aneurysms
topic thromboembolism
coil embolization
cerebral aneurysm
procedure-related factors
procedure time
url https://www.frontiersin.org/article/10.3389/fneur.2018.01125/full
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