Complications in the Endovascular Treatment of Intracranial Aneurysms

In the last two decades, neuroendovascular therapy has progressively become a more frequent treatment method for ruptured and unruptured intracranial arterial aneurysms. With development of more complex management paradigms including intrasaccular coiling, stent-assisted coiling, and flow diversion, the array of complications has also changed. Although complications are rare, they can have a significant impact on patients’ lives. Complications are related to access site complications and systemic side effects from therapy and diagnostic neuroendovascular angiography. More commonly, complications can be split into both thromboembolic and hemorrhagic with thromboembolic complication rates being between 4.7% and 12.5%, whereas the rate of intraprocedural rupture of cerebral aneurysms is approximately 0.7% in patients with unruptured aneurysms and approximately 4.1% in patients with previously ruptured aneurysms. Understanding the risk profiles, potential complications, and management paradigms to deal with these complications is important for surgeons treating intracranial aneurysms.