Format

Send to

Choose Destination
AJNR Am J Neuroradiol. 2017 Sep;38(9):1765-1770. doi: 10.3174/ajnr.A5267. Epub 2017 Jun 15.

Risk Factor Analysis of Recanalization Timing in Coiled Aneurysms: Early versus Late Recanalization.

Author information

1
From the Department of Neurosurgery (J.P.J.), Hallym University College of Medicine, Chuncheon, Korea.
2
Departments of Radiology (Y.D.C., D.H.Y., J.M.) aronnn@naver.com.
3
Departments of Radiology (Y.D.C., D.H.Y., J.M.).
4
Neurosurgery (J.L., W.-S.C., H.-S.K., J.E.K., M.H.H.), Seoul National University College of Medicine, Seoul, Korea.

Abstract

BACKGROUND AND PURPOSE:

Long-term documentation of anatomic and angiographic characteristics pertaining to the timing of recanalization in coiled aneurysms has been insufficient. Our intent was to analyze and compare early and late-phase recanalization after coiling, identifying respective risk factors.

MATERIALS AND METHODS:

A total of 870 coiled saccular aneurysms were monitored for extended periods (mean, 30.8 ± 8.3 months). Medical records and radiologic data were also reviewed, stratifying patients as either early (n = 128) or late (n = 52) recanalization or as complete occlusion (n = 690). Early recanalization was equated with confirmed recanalization within 6 months after the procedure, whereas late recanalization was defined as verifiable recanalization after imaging confirmation of complete occlusion at 6 months. A multinomial regression model served to assess potential risk factors, the reference point being early recanalization.

RESULTS:

Posterior circulation (P = .009), subarachnoid hemorrhage at presentation (P = .011), second attempt for recanalized aneurysm (P < .001), and aneurysm size >7 mm (P < .001) emerged as variables significantly linked with early recanalization (versus complete occlusion). Late (versus early) recanalization corresponded with aneurysms ≤7 mm (P = .013), and in a separate subanalysis of lesions ≤7 mm, aneurysms 4-7 mm showed a significant predilection for late recanalization (P = .008). However, the propensity for complete occlusion in smaller lesions (≤7 mm) increased as the size diminished.

CONCLUSIONS:

Although long-term complete occlusion after coiling was more likely in aneurysms ≤7 mm, such lesions were more prone to late (versus early) recanalization, particularly those of 4-7 mm in size. Long-term follow-up imaging is thus appropriate in aneurysms >4 mm to detect late recanalization of those formerly demonstrating complete occlusion.

PMID:
28619836
DOI:
10.3174/ajnr.A5267
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center