Qianqian Zhang1, Linkai Jing2, Jian Liu1, Kun Wang1, Ying Zhang1, Nikhil Paliwal3,4, Hui Meng3,4,5, Yang Wang6, Shengzhang Wang7, Xinjian Yang1. 1. Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 2. Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China. 3. Toshiba Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, New York, USA. 4. Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, New York, USA. 5. Department of Neurosurgery, University at Buffalo, The State University of New York, Buffalo, New York, USA. 6. Department of Neurosurgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China. 7. Institute of Biomechanics, Department of Aeronautics and Astronautics, Fudan University, Shanghai, China.
Abstract
BACKGROUND: The recanalization of cerebral aneurysms after endovascular embolization (coiling or stent-assisted coiling) has been a matter of concern. OBJECTIVE: To systematically evaluate the predisposing factors for cerebral aneurysm recanalization using multidimensional analysis in a large patient cohort. METHODS: In 238 patients with 283 aneurysms, patient baseline characteristics, aneurysm morphological characteristics, treatment-related factors, and changes in flow hemodynamics after endovascular treatment (coiling or stent-assisted coiling) were compared between the recanalization and non-recanalization groups. Multivariate logistic regression analysis was performed to determine independent risk factors correlated with recanalization. RESULTS: 16 aneurysms treated by coiling recanalized, with a recurrence rate of 18.6%, and 24 recanalized in the lesions treated by stent-assisted coiling, with a recanalization rate of 12.2%. Large aneurysms (>10 mm, p=0.002) and a follow-up interval >1 year (p=0.027) were shown to be statistically significant between the recanalization and non-recanalization groups. For flow hemodynamic changes, three parameters (velocity on the neck plane, wall shear stress on the neck wall, and wall shear stress on the whole aneurysm) showed a relatively lower amplitude of decrease after endovascular treatment in the recanalization group. Interestingly, the velocity on the neck plane and wall shear stress on the neck wall may be elevated after treatment. Specifically, the reduction ratio (RR) of velocity on the neck plane showed significant difference between the groups in the multivariate analysis (p=0.013), and was considered an independent risk factor for recanalization. CONCLUSIONS: The aneurysm size, follow-up interval, and flow hemodynamic changes, especially the RR of velocity on the neck plane, have important roles in aneurysm recanalization. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
BACKGROUND: The recanalization of cerebral aneurysms after endovascular embolization (coiling or stent-assisted coiling) has been a matter of concern. OBJECTIVE: To systematically evaluate the predisposing factors for cerebral aneurysm recanalization using multidimensional analysis in a large patient cohort. METHODS: In 238 patients with 283 aneurysms, patient baseline characteristics, aneurysm morphological characteristics, treatment-related factors, and changes in flow hemodynamics after endovascular treatment (coiling or stent-assisted coiling) were compared between the recanalization and non-recanalization groups. Multivariate logistic regression analysis was performed to determine independent risk factors correlated with recanalization. RESULTS: 16 aneurysms treated by coiling recanalized, with a recurrence rate of 18.6%, and 24 recanalized in the lesions treated by stent-assisted coiling, with a recanalization rate of 12.2%. Large aneurysms (>10 mm, p=0.002) and a follow-up interval >1 year (p=0.027) were shown to be statistically significant between the recanalization and non-recanalization groups. For flow hemodynamic changes, three parameters (velocity on the neck plane, wall shear stress on the neck wall, and wall shear stress on the whole aneurysm) showed a relatively lower amplitude of decrease after endovascular treatment in the recanalization group. Interestingly, the velocity on the neck plane and wall shear stress on the neck wall may be elevated after treatment. Specifically, the reduction ratio (RR) of velocity on the neck plane showed significant difference between the groups in the multivariate analysis (p=0.013), and was considered an independent risk factor for recanalization. CONCLUSIONS: The aneurysm size, follow-up interval, and flow hemodynamic changes, especially the RR of velocity on the neck plane, have important roles in aneurysm recanalization. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
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: Y Funakoshi; H Imamura; S Tani; H Adachi; R Fukumitsu; T Sunohara; Y Omura; Y Matsui; N Sasaki; T Fukuda; R Akiyama; K Horiuchi; S Kajiura; M Shigeyasu; K Iihara; N Sakai Journal: AJNR Am J Neuroradiol Date: 2020-05-07 Impact factor: 3.825
Authors: Andreas Xenofontos; Helen Raffalli-Ebezant; Aparna Madhavan; Haroon Khan; Aliya Mastan; Ian Russell; Louise Dulhanty; Hiren C Patel; Christopher A Hilditch Journal: Neuroradiol J Date: 2022-01-17
Authors: A Rizvi; S M Seyedsaadat; M Alzuabi; M H Murad; R Kadirvel; W Brinjikji; D F Kallmes Journal: AJNR Am J Neuroradiol Date: 2020-05-28 Impact factor: 3.825