INTRODUCTION: Although it is well-known that incomplete occlusion of aneurysms after coil embolization predisposes to later recanalization, not all aneurysms will be fully occluded by coiling. In follow-up, we evaluated outcomes of small aneurysms (<10 mm) that showed filling of the sac with contrast immediately after coil embolization and assessed factors implicated in subsequent progressive thrombosis. METHODS: Between January 2008 and December 2010, a total of 1035 aneurysms in 898 patients were treated by endovascular coiling. Of these, 210 small aneurysms displayed filling of the sac by contrast immediately after coil embolization. Time-of-flight magnetic resonance angiography (TOF-MRA; at 6, 12, 24, and 36 months) and digital subtraction angiography (as needed) were used for postoperative monitoring. Complete occlusion of these aneurysms at the 6-month follow-up point was attributed to progressive thrombosis. RESULTS: In 186 (88.5 %) of the 210 aneurysms that showed filling of the sac with contrast, complete occlusion was observed on follow-up imaging studies at 6 months. Multiple logistic regression analysis indicated that progressive thrombosis was linked to aneurysmal neck diameter ≤4 mm (p < 0.001) and packing density >30 % (p = 0.016). Aneurysms originating from non-branching vessels were of marginal statistical significance (p = 0.056). In 179 progressively thrombosed aneurysms with follow-up evaluations of ≥12 months (mean, 31.9 ± 7.6 months), 168 aneurysms (93.9 %) exhibited stable occlusion, whereas minor recanalization was observed in 6 (3.3 %) instances, and major recanalization occurred in 5 (2.8 %). CONCLUSIONS: In aneurysms where filling of the sac with contrast was demonstrable after coil embolization, aneurysms with small neck diameters or high coil packing density, and non-branching aneurysms seem predisposed to progressive intra-aneurysmal thrombosis over the course of time.
INTRODUCTION: Although it is well-known that incomplete occlusion of aneurysms after coil embolization predisposes to later recanalization, not all aneurysms will be fully occluded by coiling. In follow-up, we evaluated outcomes of small aneurysms (<10 mm) that showed filling of the sac with contrast immediately after coil embolization and assessed factors implicated in subsequent progressive thrombosis. METHODS: Between January 2008 and December 2010, a total of 1035 aneurysms in 898 patients were treated by endovascular coiling. Of these, 210 small aneurysms displayed filling of the sac by contrast immediately after coil embolization. Time-of-flight magnetic resonance angiography (TOF-MRA; at 6, 12, 24, and 36 months) and digital subtraction angiography (as needed) were used for postoperative monitoring. Complete occlusion of these aneurysms at the 6-month follow-up point was attributed to progressive thrombosis. RESULTS: In 186 (88.5 %) of the 210 aneurysms that showed filling of the sac with contrast, complete occlusion was observed on follow-up imaging studies at 6 months. Multiple logistic regression analysis indicated that progressive thrombosis was linked to aneurysmal neck diameter ≤4 mm (p < 0.001) and packing density >30 % (p = 0.016). Aneurysms originating from non-branching vessels were of marginal statistical significance (p = 0.056). In 179 progressively thrombosed aneurysms with follow-up evaluations of ≥12 months (mean, 31.9 ± 7.6 months), 168 aneurysms (93.9 %) exhibited stable occlusion, whereas minor recanalization was observed in 6 (3.3 %) instances, and major recanalization occurred in 5 (2.8 %). CONCLUSIONS: In aneurysms where filling of the sac with contrast was demonstrable after coil embolization, aneurysms with small neck diameters or high coil packing density, and non-branching aneurysms seem predisposed to progressive intra-aneurysmal thrombosis over the course of time.
Authors: Joanna D Schaafsma; Birgitta K Velthuis; Charles B L M Majoie; René van den Berg; Patrick A Brouwer; Frederik Barkhof; Omid Eshghi; Gerard A P de Kort; Rob T H Lo; Theo D Witkamp; Marieke E S Sprengers; Marianne A van Walderveen; Joseph C Bot; Esther Sanchez; W Peter Vandertop; Jan van Gijn; Erik Buskens; Yolanda van der Graaf; Gabriël J E Rinkel Journal: Radiology Date: 2010-05-26 Impact factor: 11.105
Authors: G Hwang; C Jung; S H Sheen; H Park; H S Kang; S H Lee; C W Oh; Y S Chung; M H Han; O K Kwon Journal: AJNR Am J Neuroradiol Date: 2010-07-15 Impact factor: 3.825
Authors: S Gallas; A C Januel; A Pasco; J Drouineau; J Gabrillargues; A Gaston; C Cognard; D Herbreteau Journal: AJNR Am J Neuroradiol Date: 2009-08-13 Impact factor: 3.825
Authors: J P Jeon; Y D Cho; J K Rhim; D H Yoo; W-S Cho; H-S Kang; J E Kim; M H Han Journal: AJNR Am J Neuroradiol Date: 2016-03-10 Impact factor: 3.825
Authors: Eun Pyo Hong; Jin Pyeong Jeon; Sung Eun Kim; Jin Seo Yang; Hyuk Jai Choi; Suk Hyung Kang; Yong Jun Cho Journal: Yonsei Med J Date: 2017-09 Impact factor: 2.759