**1. Introduction**

312 Aneurysm

*J Neuroradiol*, Vol. 29, No. 2, pp. 281-5.

*Neuroradiol*, Vol. 30, No. 7, pp. 1342-6.

results. *AJNR Am J Neuroradiol*, Vol. 25, No. 10, pp. 1742-9.

mechanical protection. *Neuroradiology*, Vol. 50, No. 12, pp. 991-8.

Prabhakaran S., Wells K. R., Lee V. H., Flaherty C. A.& Lopes D. K. (2008). Prevalence and risk factors for aspirin and clopidogrel resistance in cerebrovascular stenting. *AJNR Am* 

Saatci I., Cekirge H. S., Ozturk M. H., Arat A., Ergungor F., Sekerci Z., Senveli E., Er U., Turkoglu S., Ozcan O. E.& Ozgen T. (2004). Treatment of internal carotid artery aneurysms with a covered stent: experience in 24 patients with mid-term follow-up

Sedat J., Chau Y., Mondot L., Vargas J., Szapiro J.& Lonjon M. (2009). Endovascular occlusion of intracranial wide-necked aneurysms with stenting (Neuroform) and

Wanke I.& Forsting M. (2008). Stents for intracranial wide-necked aneurysms: more than

coiling: mid-term and long-term results. *Neuroradiology*, Vol. 51, No. 6, pp. 401-9. Wang C., Xie X., You C., Zhang C., Cheng M., He M., Sun H.& Mao B. (2009). Placement of covered stents for the treatment of direct carotid cavernous fistulas. *AJNR Am J* 

> Retroperitoneal haemorrhage has been reported as a complication of interventional surgery in less than 3% of all interventional procedures (Ellis et al. 2006, Farouque et al. 2005, Haviv et al. 1996, Kent et al. 1994, Lubavin et al. 2004, Murai et al. 2010, Nasser et al. 1995, Popma et al. 1993, Tiroch et al. 2008, Trimarchi et al. 2010, Witz et al. 1999). Technical advances in neuroendovascular therapy including aneurysm coiling (Bejjani et al.1998, Murai et al. 2005, Umeoka et al. 2010) or embolization of tumor feeders (Murai et al. 2011) have led to an overall improvement in short- and long-term outcomes of aneurysmal subarachnoid haemorrhage. However, iatrogenic complications such as haematoma or vascular dissections may still occur(Sakai et al. 2001). Although most cases of retroperitoneal haematoma are associated with blunt trauma or rupture of a diseased abdominal artery, interventional surgical accidents are another aetiology (Haviv et al. 1996, Kent et al. 1994, Lodge et al. 1973, Sreeram et al. 1993, Tomlinson et al. 2000). Retroperitoneal haematoma is a relatively rare but serious complication of femoral artery catheterization Bejjani et al. 1998, Haviv et al. 1996, Illescas et al. 1986, Kalinowski et al et al. 1998, Kent et al. 1994, Lin et al. 2001, Lodge et al. 1963, Lubavin et al. 2994, Mak et al. 1993, Quint et al. 1993, Raphael et al, 2001, Sreeram et al. 1993, Swayne et al. 1994, Trerotola et al. 1990, Wasay et al. 2001). Tiroch et al. reported a mortality rate of 12% for retroperitoneal haemorrhage patients compared with 1.3% for non-Retroperitoneal haemorrhage patients(Tiroch et al 2008). Ellis et al. reported 17 patients (10.4%) with retroperitoneal haemorrhage who expired during hospitalization (Ellis et al. 2006). Interventional radiologists and cardiologists have identified the predisposing factors, typical presentation and clinical course of this iatrogenic complication (Haviv et al. 1996, Kalinowski et al. 1998, Kent et al. 1994, Lubavin et al. 2004, Quint et al. 1993, Wita et al. 1999). However, only a small number of cases of retroperitoneal

© 2012 Murai and Teramoto, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. © 2012 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

haemorrhage have been reported following interventional neurovascular therapy because of the low incidence of this complication (Lubicz et al. 2011, Murai et al. 2010). Postangiographic retroperitoneal haemorrhage is often difficult to diagnose (Illescas et al. 1986, Sharp et al. 1984, Swayne et al. 1994, Trerotola et al. 1990, Witz et al. 1999) and can masquerade as other abdominal diseases. Symptoms are nonspecific (Kent et al. 1994, Kim et al. 2010, Murai et al. 2010, Paul et al. 2010, Raymond et al. 2001) and include abdominal, back and lower extremity pain, with abdominal distension being the most common sign. We report here a case of retroperitoneal haemorrhage following endovascular coiling of a ruptured anterior communicating artery aneurysm, with emphasis on the difficulty in diagnosing retroperitoneal haemorrhage in patients with disturbed consciousness.
