Mohamad Abdalkader1, Jean Raymond2, Asim Mian1, Varun Naragum3, Katharine Cronk4, Daniel Roy2, Alain Weill2, Thanh N Nguyen1,5,6. 1. Department of Radiology, Boston Medical Center, Boston, MA, USA. 2. Department of Radiology, Centre Hospitalier de l'Université de Montréal, University of Montreal, Montreal, Quebec, Canada. 3. Department of Radiology, UMass Memorial Medical Center, Worcester, MA, USA. 4. Department of Neurosurgery, Southern New Hampshire Health, Nashua, NH, USA. 5. Department of Neurology, Boston Medical Center, Boston, MA, USA. 6. Department of Neurosurgery, Boston Medical Center, Boston, MA, USA.
Abstract
BACKGROUND AND PURPOSE: Early major recurrence (EMR) of cerebral aneurysms treated by coiling has not been investigated. The purpose of this study is to characterize the frequency and risk factors of this phenomenon. MATERIALS AND METHODS: A retrospective review was performed of consecutive patients who presented with ruptured and unruptured cerebral aneurysms and underwent coiling from July 2009 to June 2019 at a university hospital. We defined EMR as recurrence of the aneurysm greater than its initial size within the first 6 months of an initial satisfactory coil embolization. Patient demographics, clinical information, aneurysm characteristics, angiographic and technical details were reviewed. RESULTS: From July 2009 to June 2019, 338 aneurysms (190 unruptured aneurysms and 148 ruptured cerebral aneurysms) underwent coiling and satisfied our study criteria. Among these patients, 23 patients (19 ruptured and 4 unruptured aneurysms) were found to have recurrent aneurysm. Of those, 4 were found to have early major aneurysm regrowth occurring within 6 months after coiling (1.2%). The detection of the EMR was as early as 4 weeks and as late as 20 weeks after the initial coil embolization. The average detection time was 10 ± 7.2 weeks (mean ± SD, range:4-20 weeks). In each case, the recurrent aneurysm cavity was more than twice the initial size of presentation. All aneurysms with major recurrence were ruptured with low aspect ratios (dome height to neck ratio) and involved a communicating segment. All patients underwent successful retreatment of the recurrent aneurysm with good outcome. CONCLUSIONS: Early major recurrence of treated aneurysms is a rare but important complication that harbors an impending risk of re-rupture. Early control angiography after endovascular coiling may be warranted for small ruptured aneurysms, even in cases in which the initial result seems technically satisfactory.
BACKGROUND AND PURPOSE: Early major recurrence (EMR) of cerebral aneurysms treated by coiling has not been investigated. The purpose of this study is to characterize the frequency and risk factors of this phenomenon. MATERIALS AND METHODS: A retrospective review was performed of consecutive patients who presented with ruptured and unruptured cerebral aneurysms and underwent coiling from July 2009 to June 2019 at a university hospital. We defined EMR as recurrence of the aneurysm greater than its initial size within the first 6 months of an initial satisfactory coil embolization. Patient demographics, clinical information, aneurysm characteristics, angiographic and technical details were reviewed. RESULTS: From July 2009 to June 2019, 338 aneurysms (190 unruptured aneurysms and 148 ruptured cerebral aneurysms) underwent coiling and satisfied our study criteria. Among these patients, 23 patients (19 ruptured and 4 unruptured aneurysms) were found to have recurrent aneurysm. Of those, 4 were found to have early major aneurysm regrowth occurring within 6 months after coiling (1.2%). The detection of the EMR was as early as 4 weeks and as late as 20 weeks after the initial coil embolization. The average detection time was 10 ± 7.2 weeks (mean ± SD, range:4-20 weeks). In each case, the recurrent aneurysm cavity was more than twice the initial size of presentation. All aneurysms with major recurrence were ruptured with low aspect ratios (dome height to neck ratio) and involved a communicating segment. All patients underwent successful retreatment of the recurrent aneurysm with good outcome. CONCLUSIONS: Early major recurrence of treated aneurysms is a rare but important complication that harbors an impending risk of re-rupture. Early control angiography after endovascular coiling may be warranted for small ruptured aneurysms, even in cases in which the initial result seems technically satisfactory.
Authors: Jean Raymond; François Guilbert; Alain Weill; Stavros A Georganos; Louis Juravsky; Anick Lambert; Julie Lamoureux; Miguel Chagnon; Daniel Roy Journal: Stroke Date: 2003-05-29 Impact factor: 7.914
Authors: Thanh N Nguyen; Jean Raymond; François Guilbert; Daniel Roy; Maxime D Bérubé; Mostafa Mahmoud; Alain Weill Journal: J Neurosurg Date: 2008-06 Impact factor: 5.115
Authors: J Raymond; J Ghostine; B A van Adel; J J S Shankar; D Iancu; A P Mitha; P Kvamme; R D Turner; A Turk; V Mendes-Pereira; J S Carpenter; S Boo; A Evans; H H Woo; D Fiorella; A Alaraj; D Roy; A Weill; P Lavoie; M Chagnon; T N Nguyen; J L Rempel; T E Darsaut Journal: AJNR Am J Neuroradiol Date: 2020-01-02 Impact factor: 3.825
Authors: Adriana Campi; Najib Ramzi; Andrew J Molyneux; Paul E Summers; Richard S C Kerr; Mary Sneade; Julia A Yarnold; Joan Rischmiller; James V Byrne Journal: Stroke Date: 2007-03-29 Impact factor: 7.914
Authors: Mohamad Abdalkader; Anvitha Sathya; Alice Ma; Anna M Cervantes-Arslanian; David Y Chung; Glenn Barest; Thanh N Nguyen Journal: Neuroradiol J Date: 2021-03-26