Angiographic Results of Wide-Necked Intracranial Aneurysms Treated with Coil Embolization : A Single Center Experience.
10.3340/jkns.2015.57.4.250
- Author:
Joon Ho SONG
1
;
In Bok CHANG
;
Jun Hyong AHN
;
Ji Hee KIM
;
Jae Keun OH
;
Byung Moon CHO
Author Information
1. Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea. nscib71@hanmail.net
- Publication Type:Original Article
- Keywords:
Cerebral angiography;
Intracranial aneurysm;
Recurrence
- MeSH:
Aneurysm;
Aneurysm, Ruptured;
Angiography;
Cerebral Angiography;
Embolization, Therapeutic*;
Female;
Follow-Up Studies;
Humans;
Intracranial Aneurysm*;
Male;
Recurrence;
Retreatment;
Retrospective Studies
- From:Journal of Korean Neurosurgical Society
2015;57(4):250-257
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Endovascular treatment of wide-necked intracranial aneurysms is a challenge and the durability and the safety of these treated aneurysms remain unknown. The aim of this study was to evaluate the clinical and long-term angiographic results of wide-necked intracranial aneurysms treated with coil embolization. METHODS: Between January 2002 and December 2012, 53 wide-necked aneurysms treated with coil embolization were selected. Forty were female, and 13 were male. Twenty eight (52.8%) were ruptured aneurysms, and 25 (47.2%) were unruptured aneurysms. The patents' medical and radiological records were reviewed retrospectively. RESULTS: Of the 53 aneurysms, coiling alone was employed in 45 (84.9%) and stent-assisted coiling was done in 8 (15.1%). The initial angiographic results revealed Raymond class 1 (complete occlusion) in 30 (56.6%) cases, Raymond class 2 (residual neck) in 18 (34.0%) cases, and Raymond class 3 (residual sac) in 5 (9.4%) cases. The mean angiographic follow-up period was 37.9 months (12-120 months). At the last angiographies, Raymond class 1 was seen in 26 (49.1%) cases, Raymond class 2 in 16 (30.2%), and Raymond class 3 in 11 (20.8%). Angiographic recurrence occurred in 22 (41.5%) patients, with minor recurrence in 7 (13.2%) cases and major recurrence in 15 (28.3%). Retreatment was performed in 8 cases (15.1%). A suboptimal result on the initial angiography was a significant predictor of recurrence in this study (p=0.03). CONCLUSION: The predictor of recurrence in wide-necked aneurysms is a suboptimal result on the initial angiography. Long-term angiographic follow-up is recommended in wide-necked aneurysms.
