Application and outcomes of endovascular treatment of coil embolization on ruptured intracranial aneurysms with daughter sacs

This study aimed to evaluate the feasibility and efficacy of coil embolization in patients with ruptured intracranial aneurysms (IANs) with daughter sacs (DS). A total of 56 patients with ruptured IAN in poor-grade subarachnoid hemorrhage (SAH) were enrolled. IAN was categorized into three groups according to the position of DS, including Type D, B, and N. Coil embolization was performed on 50 patients with IAN of Type D and B. Parent artery occlusion (PAO) and partial stent-supported coil embolization (SCE) were selectively performed on the left 6 patients with IAN of Type N. Perioperative complications and functional outcomes were finally assessed. Successful coil embolization of IAN of Type D and B was achieved with preserved blood flow in parent arteries, which exhibited 67.9% total occlusion, 14.3% subtotal occlusion, and 7.1% incomplete occlusion. Subtotal occlusion was also achieved by PAO and partial SCE in BTO-positive patients with IAN of Type N. The final follow-up visit showed favorable outcomes in 47 patients (83.9%), severe disability in 8 patients (14.3%) and one dead (1.8%). The recurrence rate of IAN was 19.6% during follow-up. Endovascular treatment with coil embolization was feasible and effective in patients with ruptured IAN with DS in poor-grade SAH.