Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Neuroradiology
Published in: Neuroradiology 6/2015

01-06-2015 | Interventional Neuroradiology

Progressive thrombosis of small saccular aneurysms filled with contrast immediately after coil embolization: analysis of related factors and long-term follow-up

Authors: Young Dae Cho, Jin Pyeong Jeon, Jong Kook Rhim, Jeong Jin Park, Roh-Eul Yoo, Hyun-Seung Kang, Jeong Eun Kim, Won-Sang Cho, Moon Hee Han

Published in: Neuroradiology | Issue 6/2015

Login to get access

Abstract

Introduction

Although it is well-known that incomplete occlusion of aneurysms after coil embolization predisposes to later recanalization, not all aneurysms will be fully occluded by coiling. In follow-up, we evaluated outcomes of small aneurysms (<10 mm) that showed filling of the sac with contrast immediately after coil embolization and assessed factors implicated in subsequent progressive thrombosis.

Methods

Between January 2008 and December 2010, a total of 1035 aneurysms in 898 patients were treated by endovascular coiling. Of these, 210 small aneurysms displayed filling of the sac by contrast immediately after coil embolization. Time-of-flight magnetic resonance angiography (TOF-MRA; at 6, 12, 24, and 36 months) and digital subtraction angiography (as needed) were used for postoperative monitoring. Complete occlusion of these aneurysms at the 6-month follow-up point was attributed to progressive thrombosis.

Results

In 186 (88.5 %) of the 210 aneurysms that showed filling of the sac with contrast, complete occlusion was observed on follow-up imaging studies at 6 months. Multiple logistic regression analysis indicated that progressive thrombosis was linked to aneurysmal neck diameter ≤4 mm (p < 0.001) and packing density >30 % (p = 0.016). Aneurysms originating from non-branching vessels were of marginal statistical significance (p = 0.056). In 179 progressively thrombosed aneurysms with follow-up evaluations of ≥12 months (mean, 31.9 ± 7.6 months), 168 aneurysms (93.9 %) exhibited stable occlusion, whereas minor recanalization was observed in 6 (3.3 %) instances, and major recanalization occurred in 5 (2.8 %).

Conclusions

In aneurysms where filling of the sac with contrast was demonstrable after coil embolization, aneurysms with small neck diameters or high coil packing density, and non-branching aneurysms seem predisposed to progressive intra-aneurysmal thrombosis over the course of time.
Literature
1.
Hwang G, Jung C, Sheen SH et al (2010) Two-year follow-up of contrast stasis within the sac in unruptured aneurysm coil embolization: progressive thrombosis or enlargement? AJNR Am J Neuroradiol 31:1929–1934CrossRefPubMed
2.
Gallas S, Januel AC, Pasco A et al (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 30:1986–1992CrossRefPubMed
3.
Cho YD, Lee JY, Seo JH et al (2012) Early recurrent hemorrhage after coil embolization in ruptured intracranial aneurysms. Neuroradiology 54:719–726CrossRefPubMed
4.
Baharoglu MI, Lauric A, Gao BL et al (2012) Identification of a dichotomy in morphological predictors of rupture status between sidewall- and bifurcation-type intracranial aneurysms. J Neurosurg 116:871–881CrossRefPubMed
5.
Bendok BR, Parkinson RJ, Hage ZA et al (2007) The effect of vascular reconstruction device-assisted coiling on packing density, effective neck coverage, and angiographic outcome: an in vitro study. Neurosurgery 61:835–840CrossRefPubMed
6.
Cho YD, Lee WJ, Kim KM et al (2013) Endovascular coil embolization of middle cerebral artery aneurysms of the proximal (M1) segment. Neuroradiology 55:1097–1102CrossRefPubMed
7.
Kang HS, Han MH, Kwon BJ et al (2010) Is clopidogrel premedication useful to reduce thromboembolic events during coil embolization for unruptured intracranial aneurysms? Neurosurgery 67:1371–1376CrossRefPubMed
8.
Roy D, Milot G, Raymond J (2001) Endovascular treatment of unruptured aneurysms. Stroke 32:1998–2004CrossRefPubMed
9.
Molyneux A, Kerr R, Stratton I et al (2002) International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:1267–1274CrossRefPubMed
10.
Wiebers DO, Whisnant JP, Huston J 3rd et al (2003) Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet 362:103–110CrossRefPubMed
11.
Cho YD, Sohn CH, Kang HS et al (2014) Coil embolization of intracranial saccular aneurysms using the Low-profile Visualized Intraluminal Support (LVIS™) device. Neuroradiology 56:543–551CrossRefPubMed
12.
Ferns SP, Sprengers ME, van Rooij WJ et al (2009) Coiling of intracranial aneurysms: a systematic review on initial occlusion and reopening and retreatment rates. Stroke 40:e523–529CrossRefPubMed
13.
Lee D, Yuki I, Murayama Y et al (2007) Thrombus organization and healing in the swine experimental aneurysm model. Part I. A histological and molecular analysis. J Neurosurg 107:94–108CrossRefPubMed
14.
Kwon BJ, Im SH, Park JC et al (2010) Shaping and navigating methods of microcatheters for endovascular treatment of paraclinoid aneurysms. Neurosurgery 67:34–40CrossRefPubMed
15.
Sorimachi T, Ito Y, Morita K et al (2012) Long-term follow-up of intra-aneurysmal coil embolization for unruptured paraclinoid aneurysms. Neurol Res 34:864–870CrossRefPubMed
16.
Kwon WH, Jeong HW, Kim ST et al (2014) Angiographic and clinical result of endovascular treatment in paraclinoid aneurysms. Neurointervention 9:83–88CrossRefPubMedCentralPubMed
17.
Mascitelli JR, Moyle H, Oermann EK et al (2014) An update to the Raymond-Roy Occlusion Classification of intracranial aneurysms treated with coil embolization. J Neurointerv Surg 2014 Jun 4 [Epub ahead of print]
18.
Ng P, Khangure MS, Phatouros CC et al (2002) Endovascular treatment of intracranial aneurysms with Guglielmi detachable coils: analysis of midterm angiographic and clinical outcomes. Stroke 33:210–217CrossRefPubMed
19.
Im SH, Han MH, Kwon OK et al (2009) Endovascular coil embolization of 435 small asymptomatic unruptured intracranial aneurysms: procedural morbidity and patient outcome. AJNR Am J Neuroradiol 30:79–84CrossRefPubMed
20.
Cho YD, Kim KM, Lee WJ et al (2014) Time-of-flight magnetic resonance angiography for follow-up of coil embolization with enterprise stent for intracranial aneurysm: usefulness of source images. Korean J Radiol 15:161–168CrossRefPubMedCentralPubMed
21.
Pierot L, Portefaix C, Boulin A et al (2012) Follow-up of coiled intracranial aneurysms: comparison of 3D time-of-flight and contrast-enhanced magnetic resonance angiography at 3T in a large, prospective series. Eur Radiol 22:2255–2263CrossRefPubMed
22.
Schaafsma JD, Velthuis BK, Majoie CB et al (2010) Intracranial aneurysms treated with coil placement: test characteristics of follow-up MR angiography-multicenter study. Radiology 256:209–218CrossRefPubMed
Metadata
Title
Progressive thrombosis of small saccular aneurysms filled with contrast immediately after coil embolization: analysis of related factors and long-term follow-up
Authors
Young Dae Cho
Jin Pyeong Jeon
Jong Kook Rhim
Jeong Jin Park
Roh-Eul Yoo
Hyun-Seung Kang
Jeong Eun Kim
Won-Sang Cho
Moon Hee Han
Publication date
01-06-2015
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 6/2015
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-015-1514-8

Other articles of this Issue 6/2015

Neuroradiology 6/2015 Go to the issue

Diagnostic Neuroradiology

Hidden spondylolisthesis: unrecognized cause of low back pain? Prospective study about the use of dynamic projections in standing and recumbent position for the individuation of lumbar instability

Paediatric Neuroradiology

Differential imaging characteristics and dissemination potential of pilomyxoid astrocytomas versus pilocytic astrocytomas

Interventional Neuroradiology

Patients with subarachnoid haemorrhage from vertebrobasilar dissection: treatment with stent-in-stent technique

Interventional Neuroradiology

GREAT—a randomized aneurysm trial. Design of a randomized controlled multicenter study comparing HydroSoft/HydroFrame and bare platinum coils for endovascular aneurysm treatment

Diagnostic Neuroradiology

Magnetic resonance imaging findings in patients presenting with (sub)acute cerebellar ataxia

Head and Neck Radiology

Objective and subjective image quality of primary and recurrent squamous cell carcinoma on head and neck low-tube-voltage 80-kVp computed tomography