Bing Leng1, Yongtao Zheng1, Jinma Ren2, Qiang Xu3, Yanlong Tian1, Feng Xu1. 1. Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China. 2. Center for Health Outcomes Research, University of Illinois College of Medicine at Peoria, Illinois, USA. 3. Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
Abstract
BACKGROUND AND PURPOSE: The relationship between dense packing and incidence of angiographic recurrence after endovascular treatment of intracranial aneurysms has been shown but remains controversial. We retrospectively analyzed intracranial aneurysms treated with detachable coils to determine the relation between aneurysm volume, packing, and recurrence. METHODS: We reviewed 221 aneurysms in 199 patients who underwent endovascular coiling using detachable coils from November 2009 to December 2011. Aneurysm volumes were determined using three-dimensional images obtained from rotational angiography. Aneurysm packing was defined as the ratio between the volume of coils inserted and the volume of aneurysm. At follow-up, angiographic results were dichotomized into presence or absence of recurrence. The relationship between aneurysm volume to fill, packing, and angiographic recurrence was determined by multivariable logistic regression. RESULTS: Follow-up angiography (mean follow-up 8.8 months) revealed recurrence in 14.5% of the aneurysms studied in our series. Recurrent aneurysms had a mean packing of 15.1% while stable aneurysms (non-recurrent) had a mean packing of 23.7%. Multivariable logistic regression analysis showed that aneurysm volume and packing were significantly associated with angiographic recurrence. Large volume aneurysms (>600 mm(3)) were found to have a higher incidence of recurrence than those with small volumes (OR=30.49, p<0.001). Compared with those with high packing (≥20%), the less packed aneurysms (<20%) had a higher incidence of recurrence (OR=29.01, p=0.002). There was no significant difference between aneurysm location, clinical presentation, stent assistance, duration of follow-up, and recurrence. CONCLUSIONS: Coiling large volume (>600 mm(3)) intracranial aneurysms are more likely to have a recurrence than small ones. High packing (≥20%) provides better protection against recurrence of the aneurysm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
BACKGROUND AND PURPOSE: The relationship between dense packing and incidence of angiographic recurrence after endovascular treatment of intracranial aneurysms has been shown but remains controversial. We retrospectively analyzed intracranial aneurysms treated with detachable coils to determine the relation between aneurysm volume, packing, and recurrence. METHODS: We reviewed 221 aneurysms in 199 patients who underwent endovascular coiling using detachable coils from November 2009 to December 2011. Aneurysm volumes were determined using three-dimensional images obtained from rotational angiography. Aneurysm packing was defined as the ratio between the volume of coils inserted and the volume of aneurysm. At follow-up, angiographic results were dichotomized into presence or absence of recurrence. The relationship between aneurysm volume to fill, packing, and angiographic recurrence was determined by multivariable logistic regression. RESULTS: Follow-up angiography (mean follow-up 8.8 months) revealed recurrence in 14.5% of the aneurysms studied in our series. Recurrent aneurysms had a mean packing of 15.1% while stable aneurysms (non-recurrent) had a mean packing of 23.7%. Multivariable logistic regression analysis showed that aneurysm volume and packing were significantly associated with angiographic recurrence. Large volume aneurysms (>600 mm(3)) were found to have a higher incidence of recurrence than those with small volumes (OR=30.49, p<0.001). Compared with those with high packing (≥20%), the less packed aneurysms (<20%) had a higher incidence of recurrence (OR=29.01, p=0.002). There was no significant difference between aneurysm location, clinical presentation, stent assistance, duration of follow-up, and recurrence. CONCLUSIONS: Coiling large volume (>600 mm(3)) intracranial aneurysms are more likely to have a recurrence than small ones. High packing (≥20%) provides better protection against recurrence of the aneurysm. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Anthony J Boyle; Mark A Wierzbicki; Scott Herting; Andrew C Weems; Adam Nathan; Wonjun Hwang; Duncan J Maitland Journal: Med Eng Phys Date: 2017-07-31 Impact factor: 2.242
Authors: Robert J Damiano; Vincent M Tutino; Nikhil Paliwal; Tatsat R Patel; Muhammad Waqas; Elad I Levy; Jason M Davies; Adnan H Siddiqui; Hui Meng Journal: J Neurointerv Surg Date: 2019-12-17 Impact factor: 5.836
Authors: Jimmy Ghostine; Naim Khoury; Francis Cloutier; Marc Kotowski; Jean-Christophe Gentric; André L Batista; Alain Weill; Daniel Roy; Tim E Darsaut; Jean Raymond Journal: Interv Neuroradiol Date: 2016-08-16 Impact factor: 1.610
Authors: Francis Cloutier; Naim Khoury; Jimmy Ghostine; Behzad Farzin; Marc Kotowski; Alain Weill; Daniel Roy; Jean Raymond Journal: Interv Neuroradiol Date: 2016-10-22 Impact factor: 1.610
Authors: Justin R Mascitelli; Eric K Oermann; J Mocco; Johanna T Fifi; Srinivasan Paramasivam; Christopher J Stapleton; Aman B Patel Journal: Interv Neuroradiol Date: 2015-06-19 Impact factor: 1.610