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Clinical Neuroradiology
Published in: Clinical Neuroradiology 2/2017

01-06-2017 | Original Article

Do Contrast-Fill Patterns Immediately After Coil Embolization of Small Saccular Aneurysms Impact Long-Term Results?

Authors: J.P. Jeon, MD, Y.D. Cho, MD, J.K. Rhim, MD, D.H. Yoo, MD, H.-S. Kang, MD, PhD, J.E. Kim, MD, PhD, W.S. Cho, MD, PhD, M.H. Han, MD, PhD

Published in: Clinical Neuroradiology | Issue 2/2017

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Abstract

Purpose

It is generally accepted that filling of a saccular aneurysm with contrast immediately after coil embolization predisposes to later recanalization. However, not all such scenarios evolve similarly over time. We investigated outcomes of small (≤ 7 mm) aneurysms with contrast-filled sacs immediately after coil embolization, evaluating the impact of pattern and degree of filling on subsequent recanalization.

Methods

Between January, 2008 and December, 2010, 186 small (≤ 7 mm) saccular aneurysms that retained contrast after coil embolization accrued for this study. Lesions were categorized by pattern (eccentric vs. concentric) and degree of filling on working projections. Clinical and morphologic factors were also analyzed to assess impact on subsequent recanalization. Morphologic outcomes at 6 months or more were assessed.

Results

In 93.5 % (174/186) of aneurysms with visible contrast retention, complete occlusion was evident on follow-up imaging studies at 6 months. Multiple logistic regression analysis indicated that eccentric (vs. concentric) contrast filling carried greater risk of subsequent recanalization (p = 0.020). Stent placement and progressive occlusion were also linked, falling short of statistical significance (p = 0.089). Of 166 progressively occluded aneurysms followed for more than 12 months (mean, 30.8 ± 7.3 months), 158 (95.2 %) exhibited stable occlusion.

Conclusion

Small (≤ 7 mm) aneurysms that retain contrast immediately after coil embolization are more likely to become completely occluded over time through progressive thrombosis. However, an eccentric fill pattern may predispose to recanalization.
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Metadata
Title
Do Contrast-Fill Patterns Immediately After Coil Embolization of Small Saccular Aneurysms Impact Long-Term Results?
Authors
J.P. Jeon, MD
Y.D. Cho, MD
J.K. Rhim, MD
D.H. Yoo, MD
H.-S. Kang, MD, PhD
J.E. Kim, MD, PhD
W.S. Cho, MD, PhD
M.H. Han, MD, PhD
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
Clinical Neuroradiology / Issue 2/2017
Print ISSN: 1869-1439
Electronic ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-015-0485-9

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