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After the International Subarachnoid Trial reported favorable outcomes in a coiling group in treatment for ruptured cerebral aneurysms, we decided to treat ruptured aneurysms by coiling as our primary choice. In this paper, we report our clinical results over the past three years (2008–2011) and discuss the results and limitations of coiling. Of 119 aneurysms, we performed clipping in 54 cases and coiling in 65 cases. Many anterior (Acom) and posterior communicating artery aneurysms were treated by coiling. On the other hand, most middle cerebral aneurysms were cured by clipping in this series. Hospitalization tended to be slightly shortened, and neurological status was slightly better in the coiling group at discharge. Coiling appeared to be effective in treatment for more than half of ruptured aneurysms. However, in this study, coiling was difficult in a few Acom aneurysms because of their shape and access route up to the aneurysms. Moreover, attention must be paid to rebleeding and retreatment, especially when primary coiling is not done perfectly.

Clinical Result and Limitation of Coil Embolization for Ruptured Cerebral Aneurysms as Primary Choice