Preventive coil embolization of unruptured intracranial aneurysms in adults with homozygous sickle cell disease

BACKGROUND: Intracranial aneurysms (IAs) are more prevalent and rupture at smaller sizes in adults with sickle cell disease (SCD), compared with the general population, but evidence regarding treatment outcomes remains limited. OBJECTIVE: To evaluate the safety and efficacy of coil embolization for unruptured IAs in adults with SCD. METHODS: We retrospectively reviewed consecutive adults with homozygous sickle cell disease (HbSS) who underwent elective coil embolization for unruptured IAs between 2010 and 2023. Clinical, hematological, procedural, and radiological data were analyzed. Primary endpoints were immediate and long term angiographic occlusion and periprocedural complications. Durable occlusion was defined as Raymond-Roy Occlusion Classification class I-II at the last follow-up. RESULTS: 25 patients with HbSS (median age 50 years; 76% women) with 35 aneurysms were treated. All patients received exchange transfusion to sickle hemoglobin