Objective To explore the risk factors for recurrence of intracranial ruptured cystic an-eurysm(ISA)in elderly patients after endovascular coil embolization and provide corresponding management strategies.Methods A retrospective analysis was conducted on 204 ISA patients 60 years old)receiving endovascular coiling in Bijie Branch of Zhejiang Provincial People's Hospi-tal from January 2017 to December 2023.According to the presence of aneurysm recurrence or not,they were divided into a recurrence group(32 cases)and a non-recurrence group(172 cases).The recurrent aneurysms included 10 cases of type Ⅰ,7 cases of type Ⅱ,13 cases of type Ⅲ,and 2 cases of type Ⅳ.Multivariate logistic regression analysis was used to identify the risk factors for arterial aneurysm recurrence,and ROC curve analysis was used to determine the predictive per-formance of our model.Results There was significant difference in the occlusion classes of Modi-fied Raymond-Roy Classification(MRRC)immediately after surgery between the recurrence group and the non-recurrence group(P=0.007).The recurrence group had obviously larger pro-portions of recurrent aneurysms with a maximum diameter of ≥10 mm,immediate MRRC occlu-sion classes Ⅱ～Ⅲb,and volume embolization ratio(VER)＜20％,and lower ratios of immediate MRRC occlusion class Ⅰ and using stent assisted techniques when compared with the non-recur-rent group(P＜0.05,P＜0.01).Multivariate logistic regression analysis indicated that maximum diameter of aneurysm ≥10 mm,postoperative MRRC occlusion class Ⅲb,and VER＜20％were independent risk factors for ISA recurrence(P＜0.05,P＜0.01).The patients with types Ⅲ andⅣ recurrent aneurysms had increased ratios of maximum diameter of aneurysm ≥10 mm and VER＜20％than those with types Ⅰ and Ⅱ(P＜0.05).The patients with recurrent type Ⅲ andⅣ aneurysms received endovascular treatment after recurrence.Conclusion Larger diameter of aneurysm,MRRC grade Ⅲb immediately after surgery,and lower VER are independent risk fac-tors for ISA recurrence in elderly patients undergoing coil embolization.In addition,it is recom-mended that the patients with recurrent type Ⅲ or Ⅳ aneurysms should undergo immediate re-treatment.

Objective To explore the risk factors for recurrence of intracranial ruptured cystic an-eurysm(ISA)in elderly patients after endovascular coil embolization and provide corresponding management strategies.Methods A retrospective analysis was conducted on 204 ISA patients 60 years old)receiving endovascular coiling in Bijie Branch of Zhejiang Provincial People's Hospi-tal from January 2017 to December 2023.According to the presence of aneurysm recurrence or not,they were divided into a recurrence group(32 cases)and a non-recurrence group(172 cases).The recurrent aneurysms included 10 cases of type Ⅰ,7 cases of type Ⅱ,13 cases of type Ⅲ,and 2 cases of type Ⅳ.Multivariate logistic regression analysis was used to identify the risk factors for arterial aneurysm recurrence,and ROC curve analysis was used to determine the predictive per-formance of our model.Results There was significant difference in the occlusion classes of Modi-fied Raymond-Roy Classification(MRRC)immediately after surgery between the recurrence group and the non-recurrence group(P=0.007).The recurrence group had obviously larger pro-portions of recurrent aneurysms with a maximum diameter of ≥10 mm,immediate MRRC occlu-sion classes Ⅱ～Ⅲb,and volume embolization ratio(VER)＜20％,and lower ratios of immediate MRRC occlusion class Ⅰ and using stent assisted techniques when compared with the non-recur-rent group(P＜0.05,P＜0.01).Multivariate logistic regression analysis indicated that maximum diameter of aneurysm ≥10 mm,postoperative MRRC occlusion class Ⅲb,and VER＜20％were independent risk factors for ISA recurrence(P＜0.05,P＜0.01).The patients with types Ⅲ andⅣ recurrent aneurysms had increased ratios of maximum diameter of aneurysm ≥10 mm and VER＜20％than those with types Ⅰ and Ⅱ(P＜0.05).The patients with recurrent type Ⅲ andⅣ aneurysms received endovascular treatment after recurrence.Conclusion Larger diameter of aneurysm,MRRC grade Ⅲb immediately after surgery,and lower VER are independent risk fac-tors for ISA recurrence in elderly patients undergoing coil embolization.In addition,it is recom-mended that the patients with recurrent type Ⅲ or Ⅳ aneurysms should undergo immediate re-treatment.