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Neuroradiology

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01-06-2012 | Interventional Neuroradiology

Factors predicting retreatment and residual aneurysms at 1 year after endovascular coiling for ruptured cerebral aneurysms: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan

Authors: Waro Taki, PRESAT group

Published in: Neuroradiology | Issue 6/2012

Abstract

Introduction

Endovascular treatment of cerebral aneurysms includes follow-up imaging to identify aneurysms that may need retreatment. The aim of this study was to determine predictors of incomplete aneurysm occlusion at 1 year after endovascular coiling for ruptured cerebral aneurysms.

Methods

In 129 patients of the Prospective Registry of Subarachnoid Aneurysms Treatment cohort, ruptured aneurysms were coiled within 14 days of onset and both initial post-coiling and 1-year follow-up digital subtraction angiography or magnetic resonance angiography were obtained. Factors predicting 1-year incomplete aneurysm occlusion (retreatment within 1-year or residual aneurysms at 1 year) were determined using multivariate logistic regression analyses.

Results

One-year incomplete aneurysm occlusion was identified in 59 patients, including ten patients who were retreated within 1-year post-coiling. Dome size ≥7.5 mm (P = 0.007, odds ratio (OR) = 5.00, 95% confidence interval (CI) = 1.55–16.15), pre-treatment aneurysm re-rupture (P = 0.023, OR = 3.50, 95% CI = 1.19–10.31), non-small size/small neck aneurysm (dome size, ≥10 mm or neck size, ≥4 mm; P = 0.022, OR = 3.26, 95% CI = 1.19–8.96), and residual aneurysms on immediate post-coiling angiograms (P = 0.017, OR = 1.43, 95% CI = 1.07–1.93) significantly predicted incomplete aneurysm occlusion at 1-year post-coiling.

Conclusions

In addition to the characteristics of aneurysm and initially incomplete aneurysm occlusion, this study showed pre-treatment aneurysm re-rupture to be a predictor that favors closer imaging follow-ups for coiled aneurysms.

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International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group (2002) International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:1267–1274CrossRef

Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P, for the International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group (2005) International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809–817PubMedCrossRef

Byrne JV, Sohn MJ, Molyneux AJ (1999) Five year experience in using coil embolisation of ruptured intracranial aneurysms: outcomes and incidence of late re-bleeding. J Neurosurg 90:656–663PubMedCrossRef

van Rooij WJ, Sluzewski M (2009) Opinion: imaging follow-up after coiling of intracranial aneurysms. AJNR Am J Neuroradiol 30:1646–1648PubMedCrossRef

Raymond J, Guilbert F, Weill A, Georganos SA, Juravsky L, Lambert A, Lamoureux J, Chagnon M, Roy D (2003) Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke 34:1398–1403PubMedCrossRef

Ries T, Siemonsen S, Thomalla G, Grzyska U, Zeumer H, Fiehler J (2007) Long-term follow-up of cerebral aneurysms after endovascular therapy prediction and outcome of retreatment. AJNR Am J Neuroradiol 28:1755–1761PubMedCrossRef

Sluzewski M, van Rooij WJ, Rinkel GJ, Wijnalda D (2003) Endovascular treatment of ruptured intracranial aneurysms with detachable coils: long-term clinical and serial angiographic results. Radiology 227:720–724PubMedCrossRef

Sluzewski M, van Rooij WJ, Beute GN, Nijssen PC (2005) Late rebleeding of ruptured intracranial aneurysms treated with detachable coils. AJNR Am J Neuroradiol 26:2542–2549PubMed

Holmin S, Krings T, Ozanne A, Alt JP, Claes A, Zhao W, Alvarez H, Rodesch G, Lasjaunias P (2008) Intradural saccular aneurysms treated by Guglielmi detachable bare coils at a single institution between 1993 and 2005: clinical long-term follow-up for a total of 1810 patient-years in relation to morphological treatments results. Stroke 39:2288–2297PubMedCrossRef

10.

Ferns SP, Sprengers MES, van Rooij WJ, Rinkel GJE, van Rijn JC, Bipat S, Sluzewski M, Majoie CBLM (2009) Coiling of intracranial aneurysms: a systematic review on initial occlusion and reopening and retreatment rates. Stroke 40:e523–e529PubMedCrossRef

11.

Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) Group (2011) Determinants of poor outcome following aneurysmal subarachnoid hemorrhage when both clipping and coiling are available: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan. World Neurosurg (in press)

12.

Drake CG (1988) Report of World Federation of Neurological Surgeons Committee on a universal subarachnoid hemorrhage grading scale. J Neurosurg 68:985–986, Letter

13.

Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 6:1–9PubMedCrossRef

14.

Lyden PD, Lau GT (1991) A critical appraisal of stroke evaluation and rating scales. Stroke 22:1345–1352PubMedCrossRef

15.

Roy D, Milot G, Raymond J (2001) Endovascular treatment of unruptured aneurysms. Stroke 32:1998–2004PubMedCrossRef

16.

Raymond J, Roy D (1997) Safety and efficacy of endovascular treatment of acutely ruptured aneurysms. Neurosurgery 41:1235–1245PubMedCrossRef

17.

Murayama Y, Nien YL, Duckwiler G, Gobin YP, Jahan R, Frazee J, Martin N, Vinuela F (2003) Guglielmi detachable coil embolization of cerebral aneurysms: 11 years’ experience. J Neurosurg 98:959–966PubMedCrossRef

18.

van Rooij WJ, Sprengers ME, Sluzewski M, Beute GN (2007) Intracranial aneurysms that repeatedly reopen over time after coiling: imaging characteristics and treatment outcome. Neuroradiology 49:343–349PubMedCrossRef

19.

Kang HS, Han MH, Kwon BJ, Kwon OK, Kim SH (2006) Repeat endovascular treatment in post-embolization recurrent intracranial aneurysms. Neurosurgery 58:60–70PubMedCrossRef

20.

Gallas S, Januel AC, Pasco A, Drouineau J, Gabrillargues J, Gaston A, Cognard C, Herbreteau D (2009) Long-term follow-up of 1036 cerebral aneurysms treated by bare coils: a multicentric cohort treated between 1998 and 2003. AJNR Am J Neuroradiol 30:1986–1992PubMedCrossRef

21.

Campi A, Ramzi N, Molyneux AJ, Summers PE, Kerr RS, Sneade M, Yarnold JA, Rischmiller J, Byrne JV (2007) Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial (ISAT). Stroke 38:1538–1544PubMedCrossRef

22.

Thornton J, Debrun GM, Aletich VA, Bashir Q, Charbel FT, Ausman J (2002) Follow up angiography of intracranial aneurysms treated with endovascular placement of Guglielmi detachable coils. Neurosurgery 50:239–250PubMed

23.

Meyers PM, Schumacher HC, Higashida RT, Derdeyn CP, Nesbit GM, Sacks D, Wechsler LR, Bederson JB, Lavine SD, Rasmussen P (2009) Reporting standards for endovascular repair of saccular intracranial cerebral aneurysms. Stroke 40:e366–e379PubMedCrossRef

24.

Pierot L, Leclerc X, Bonafé A, Bracard S, Investigators French Matrix Registry (2008) Endovascular treatment of intracranial aneurysms with Matrix detachable coils: midterm anatomical follow-up from a prospective multicenter registry. AJNR Am J Neuroradiol 29:57–61PubMedCrossRef

25.

Pierot L, Cognard C, Ricolfi F, Anxionnat R, for the CLARITY Investigators (2010) Immediate anatomic results after the endovascular treatment of ruptured intracranial aneurysms: analysis in the CLARITY series. AJNR Am J Neuroradiol 31:907–911PubMedCrossRef

26.

Gallas S, Pasco A, Cottier JP, Gabrillargues J, Drouineau J, Cognard C, Herbreteau D (2005) A multicenter study of 705 ruptured intracranial aneurysms treated with Guglielmi detachable coils. AJNR Am J Neuroradiol 26:1723–1731PubMed

27.

Cognard C, Weill A, Spelle L, Piotin M, Castaings L, Rey A, Moret J (1999) Long term angiographic follow-up of 169 intracranial berry aneurysms occluded with detachable coils. Radiology 212:348–356PubMed

28.

Schaafsma JD, Sprengers ME, van Rooij WJ, Sluzewski M, Majoie CB, Wermer MJ, Rinkel GJ (2009) Long-term recurrent subarachnoid hemorrhage after adequate coiling versus clipping of ruptured intracranial aneurysms. Stroke 40:1758–1763PubMedCrossRef

29.

Bederson JB, Connolly ES Jr, Batjer HH, Dacey RG, Dion JE, Diringer MN, Duldner JE Jr, Harbaugh RE, Patel AB, Rosenwasser RH (2009) Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke 40:994–1025PubMedCrossRef

30.

Derdeyn CP, Graves VB, Turski PA, Masaryk AM, Strother CM (1997) MR angiography of saccular aneurysms after treatment with Guglielmi detachable coils: preliminary experience. AJNR Am J Neuroradiol 18:279–286PubMed

31.

Farb RI, Nag S, Scott JN, Willinsky RA, Marotta TR, Montanera WJ, Tomlinson G, Terbrugge KG (2005) Surveillance of intracranial aneurysms treated with detachable coils: a comparison of MRA techniques. Neuroradiology 47:507–515PubMedCrossRef

32.

Sprengers ME, Schaafsma J, van Rooij WJ, Sluzewski M, Rinkel GJ, Velthuis BK, van Rijn JC, Majoie CB (2008) Stability of intracranial aneurysms adequately occluded 6 months after coiling: a 3 T MR angiography multicenter long-term follow-up study. AJNR Am J Neuroradiol 29:1768–1774PubMedCrossRef

33.

Sluzewski M, van Rooij WJ, Slob MJ, Bescos JO, Slump CH, Wijnalda D (2004) Relation between aneurysm volume, packing, and compaction in145 cerebral aneurysms treated with coils. Radiology 231:653–658PubMedCrossRef

34.

Richling B, Gruber A, Bavinzski G, Killer M (1995) GDC-system embolization for brain aneurysms: location and follow-up. Acta Neurochir 134:177–183CrossRef

Title: Factors predicting retreatment and residual aneurysms at 1 year after endovascular coiling for ruptured cerebral aneurysms: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan
Authors: Waro Taki
PRESAT group
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 6/2012
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-011-0945-0

2024 ASCO Annual Meeting

Springer Medicine

Factors predicting retreatment and residual aneurysms at 1 year after endovascular coiling for ruptured cerebral aneurysms: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan

Abstract

Introduction

Methods

Results

Conclusions

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

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