Abstract

Aim: Subarachnoid hemorrhage (SAH) caused by ruptured intracranial aneurysms (RICAs) is a significant source of morbidity and mortality. This study seeks to assess the safety and efficacy of endovascular simple coiling (SC) in patients treated during the acute phase of RICA.
Materials and Methods: We retrospectively analyzed 127 patients who underwent SC for aneurysmal SAH (aSAH) from January 2019 to August 2025. We assessed demographic information, aneurysm details, and occlusion rates. Primary endpoints included rebleeding, perioperative complications, and mortality. Data regarding aneurysm size were analyzed for normality; given the non-normal distribution typical of vascular pathologies, the mean and standard deviation were retained for consistency with comparable literature.
Results: The study comprised 127 patients (mean age 57.0± 12.6 years; 76 females, 59.8%). The internal carotid artery was the most frequently observed aneurysm location (35.5%). The remaining 25.5% of aneurysms were located in the posterior circulation or other segments, including the posterior communicating artery (n=14), basilar artery (n=8), vertebral artery (n=6), distal anterior cerebral artery (n=3), and superior cerebellar artery (n=1). The mean aneurysm diameter was 9.0±5.6 mm. Complete aneurysm occlusion (Raymond-Roy Class 1) was achieved in 35 patients (27.6%). At the 1-year follow-up, the overall mortality rate stood at 20.5% (26 of 127). Rebleeding occurred in 2 patients (1.6%). The remaining 24 deaths were attributed to the severity of the initial subarachnoid hemorrhage (e.g., intracranial hypertension, brain edema) or delayed cerebral ischemia due to severe vasospasm, rather than procedural complications.
Conclusion: SC remains an effective and safe option for appropriate candidates. It offers low perioperative complication rates and acceptable aneurysm occlusion rates, prioritizing safety by avoiding the risks of dual antiplatelet therapy required for stent-assisted procedures.

Key words: Subarachnoid hemorrhage, endovascular simple coiling, ruptured intracranial aneurysms