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Neuroradiology
Published in: Neuroradiology 5/2018

01-05-2018 | Interventional Neuroradiology

Risk factor analysis of recanalization and retreatment for patients with endovascular treatment of internal carotid artery bifurcation aneurysms

Authors: Seung Pil Ban, Gyojun Hwang, Chang Hyeun Kim, Hyoung Soo Byoun, Si Un Lee, Tackeun Kim, Jae Seung Bang, Chang Wan Oh, O-Ki Kwon

Published in: Neuroradiology | Issue 5/2018

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Abstract

Purpose

Only a few reports of internal carotid artery (ICA) bifurcation aneurysms using the endovascular technique have been published in the current literature. The purpose of this study was to assess how multiple risk factors including angioarchitectural features of ICA bifurcation characteristics may have influenced aneurysmal rupture, recanalization, and retreatment.

Methods

Fifty-one patients with 52 ICA bifurcation aneurysms treated with endovascular coiling between July 2003 and July 2015 were retrospectively analyzed. The patients’ clinical records, endovascular reports, and clinical and angiographic outcomes were reviewed. We also evaluated risk factors for recanalization and retreatment, including the angioarchitectural anatomy.

Results

The clinical outcomes were observed to be satisfactory in 49 patients (96.0%) and unfavorable in 2 patients (4.0%). The risk factor for aneurysmal rupture was young age (P = 0.024). Symptomatic complications due to thromboembolism occurred in 1.9% of cases; no patients suffered a fatal complication. Eleven of 52 ICA bifurcation aneurysms (21.2%) were recanalized within an average of 54.3 ± 33.5 months of follow-up. Among the aneurysms, 4 (7.7%) underwent recoiling. Multivariate analysis showed that ruptured aneurysms (P = 0.006) and a lower packing density (P = 0.048) were risk factors for recanalization. A lower packing density was the only risk factor for retreatment (P = 0.019).

Conclusion

Endovascular treatment of ICA bifurcation aneurysms is considered safe and acceptable. This study showed that the ICA bifurcation aneurysms ruptured more frequently at a younger age. A higher packing density has been shown to reduce major recanalization and retreatment.
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Metadata
Title
Risk factor analysis of recanalization and retreatment for patients with endovascular treatment of internal carotid artery bifurcation aneurysms
Authors
Seung Pil Ban
Gyojun Hwang
Chang Hyeun Kim
Hyoung Soo Byoun
Si Un Lee
Tackeun Kim
Jae Seung Bang
Chang Wan Oh
O-Ki Kwon
Publication date
01-05-2018
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 5/2018
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-018-2013-5

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