Risk factors for coil protrusion into the parent artery and associated XXXX following @entity438 .

@entity438 @entity887 @entity439 @entity1188 @entity385
OBJECTIVE: Advances in vascular reconstruction devices and coil technologies have made coil embolization a popular and effective strategy for treatment of relatively wide-neck @entity438 . However, coil protrusion occurs occasionally, and little is known about the frequency, the risk factors and the risk of @entity887 . METHOD: We assessed the frequency and the risk factors for coil protrusion in 330 unruptured @entity439 cases, and examined the occurrence of @entity385 by diffusion-weighted magnetic resonance imaging (DW-MRI). RESULT: Forty-four instances of coil protrusion were encountered during coil embolization (13.3% of cases), but incidence was reduced to 33 (10% of cases) by balloon press or insertion of the next coil. Coil protrusion occurred more frequently during the last phase of the procedure, and both a wide neck (large fundus to neck ratio) (OR   =   1.84, P   =   0.03) and an inadequately stable neck frame (OR   =   5.49, P   =   0.0007) increased protrusion risk. Coil protrusions did not increase the incidence of high-intensity lesions ( @entity1188 ) on DW-MRI (33.3% vs 29% of cases with no coil protrusion). However, longer operation time did increase infarct risk (P   =   0.0003). Thus, tail or loop type coil protrusion did not increase the risk of @entity887 , if adequate blood flow was maintained. CONCLUSION: Coil protrusion tended to occur more frequently in cases of @entity439 with loose neck framing. Moderate and less coil protrusion carries no additional thrombo-embolic risk, if blood flow is maintained, which can be aided by additional post-operative antiplatelet therapy.
