Coiling of truly incidental intracranial aneurysms.

BACKGROUND AND PURPOSE: The purpose of this study is to report the morbidity, mortality, and angiographic results of coiling of asymptomatic incidental aneurysms and compare the characteristics of these aneurysms with other asymptomatic incidental aneurysms that were not treated. PATIENTS AND METHODS: During a 10-year period, 97 patients without previous subarachnoid hemorrhage, presented with incidentally found intracranial aneurysms. In 48 patients, 58 aneurysms were coiled. The mean size of the 58 coiled incidental aneurysms was 10.9 mm (median, 9 mm; range, 3–40 mm). Twenty-six of 58 coiled aneurysms (44.8%) were ≥10 mm. RESULTS: Permanent morbidity of coiling was 2.1% (1 of 48), mortality was 0%. Compared with untreated patients with incidental aneurysms, coiled patients were younger and more often had multiple aneurysms. Aneurysms of coiled patients more often had a small neck, were more often located on the carotid artery, and were less often located on the middle cerebral artery. Of 46 aneurysms with angiographic follow up, 45 were completely or near completely occluded. To obtain these results, 3 aneurysms were coiled more than once. Coiled incidental aneurysms did not rupture during a median follow-up period of 28.5 months. Mean hospital stay per patient was 2.5 days. CONCLUSION: Coiling of incidental intracranial aneurysms has a low complication rate in selected aneurysms and patients. Coiling should be the first treatment option in incidental aneurysms suitable for this technique.