Coil embolisation of unruptured intracranial aneurysms

Current evidence suggests that coil embolisation is efficacious in obliterating unruptured intracranial aneurysms and that its safety is similar to that of surgical treatment.

The annual risk of haemorrhage from unruptured intracranial aneurysms varies widely, depending on their site and size; and the lifetime risk depends on life expectancy and other factors. The decision to treat unruptured intracranial aneurysms by coil embolisation therefore requires judgement of the risks for each patient, and recognition of the importance of patient choice. Clinicians wishing to undertake this procedure should ensure that:

• normal arrangements are in place for audit and clinical governance

• patients understand the relative risks of coil embolisation and surgery compared to the risk of having no treatment when giving their consent for this treatment. Use of NICE's information for the public on coil embolisation of unruptured cranial aneurysms is recommended.

The procedure should only be performed in specialist units with expertise in the endovascular treatment of intracranial aneurysms.