Top

Published in:

01-01-2007 | Interventional Neuroradiology

Recanalization after endovascular treatment of intracerebral aneurysms

Authors: Iris Q. Grunwald, Panagiotis Papanagiotou, Tobias Struffert, Maria Politi, Christoph Krick, Gökmen Gül, Wolfgang Reith

Published in: Neuroradiology | Issue 1/2007

Abstract

Introduction

The aim of this study was to evaluate the risks of endovascular therapy, aneurysm regrowth, recanalization and the need for reembolization.

Method

A prospective analysis was performed on 211 aneurysms treated endovascularly from February 2000 to December 2003. Of these 211 aneurysms, 81 were asymptomatic and 130 were ruptured. The risks of endovascular therapy, aneurysm regrowth, recanalization and the need for reembolization were evaluated.

Results

The mean observation time was 10 months (ranging from 178 to 830 days). Complete occlusion (100%) in the initial intervention was achieved in 171 of 201 aneurysms (85%), 80–95% occlusion in 24 aneurysms (12%), and <80% occlusion in 6 aneurysms (3%). Recanalization had occurred at the first follow-up in 34 of all 153 aneurysms reassessed (22.2%). Of 133 aneurysms with initial 100% occlusion, 107 (80.4%) remained completely occluded, 17 (12.7%) showed recanalization, and 9 (6.7%) showed neck regrowth. Among those with 80–95% occlusion, 20 were reassessed, and of these 2 showed spontaneous occlusion, 10 (50%) still showed the initial neck, and 8 (40%) showed increased recanalization. One aneurysm which initially showed <80% occlusion remained unchanged, and another showed showed recanalization. Of the 153 aneurysms, 12 (7.8%) were recoiled, 2 initially <80% occluded, 7 initially 80–95% occluded and 3 initially totally occluded.

Conclusion

In spite of low morbidity and mortality, one in four aneurysms will show recurrence. The initial degree of occlusion seems to have an influence on the likelihood of recanalization.

Halbach VV, Higashida RT, Dowd CF, Barnwell SL, Fraser KW, Smith TP, Teitelbaum GP, Hieshima GB (1994) The efficacy of endosaccular aneurysm occlusion in alleviating neurological deficits produced by mass effect. J Neurosurg 80:659–666PubMed

Guglielmi G, Vinuela F, Dion J, Duckwiler G (1991) Electrothrombosis of saccular aneurysms via endovascular approach. II. Preliminary clinical experience. J Neurosurg 75:8–14PubMed

Guglielmi G, Vinuela F, Duckwiler G, Dion J, Lylyk P, Berenstein A, Strother C, Graves V, Halbach V, Nichols D et al (1992) Endovascular treatment of posterior circulation aneurysms by electrothrombosis using electrically detachable coils. J Neurosurg 77:515–524PubMed

Massoud T, Guglielmi G, Vinuela F, Duckwiler G (1996) Endovascular treatment of multiple aneurysms involving the posterior intracranial circulation. AJNR Am J Neuroradiol 17:549–554PubMed

Fernandez Zubillaga A, Guglielmi G, Vinuela F, Duckwiler GR(1994) Endovascular occlusion of intracranial aneurysms with electrically detachable coils: correlation of aneurysm neck size and treatment results. AJNR Am J Neuroradiol 15:815–820PubMed

Raymond J, Roy D, Bojanowski M, Moumdjian R, L’Esperance G (1997) Endovascular treatment of acutely ruptured and unruptured aneurysms of the basilar bifurcation. J Neurosurg 86:211–219PubMedCrossRef

Graves VB, Strother CM, Duff TA, Perl J (1995) Early treatment of ruptured aneurysms with Guglielmi detachable coils: effects on subsequent bleeding. Neurosurgery 37:640–648PubMedCrossRef

Hodes JE, Fox AJ, Pelz DM, Peerless SJ (1990) Rupture of aneurysms following balloon embolization. J Neurosurg 72:567–571PubMed

Casasco AE, Aymard A, Gobin YP, Houdart E, Rogopoulos A, George B, Hodes JE, Cophignon J, Merland JJ (1993) Selective endovascular treatment of 71 intracranial aneurysms with platinum coils. J Neurosurg 79:3–10PubMed

10.

Gurian JH, Martin NA, King W, Duckwiler G, Guglielmi G, Vinuela F (1995) Neurosurgical management of cerebral aneurysms following unsuccessful or incomplete embolization. J Neurosurg 83:843–853PubMed

11.

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

12.

Brilstra EH, Rinkel GJE, van der Graaf Y, van Rooij WJJ, Algra A (1999) Treatment of intracranial aneurysms by embolization with coils: a systemic review. Stroke 30:470–476PubMed

13.

Hodgson TJ, Carroll T, Jellinek DA (1998) Subarachnoid hemorrhage due to late recurrence of a previously unruptured aneurysm after complete endovascular occlusion. AJNR Am J Neuroradiol 19:1939–1941PubMed

14.

Tsutsumi K, Ueki K, Usui M, Kwak S, Kirino T (1998) Risk of recurrent subarachnoid hemorrhage after complete obliteration of cerebral aneurysms. Stroke 29:2511–2513PubMed

15.

Byrne JV, Sohn MJ, Molyneux AJ, Chir B (1999) Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. J Neurosurg 90:656–663PubMed

16.

Thornton J, Bashir Q, Aletich VA, Debrun GM, Ausman JI, Charbel FT (2000) What percentage of surgically clipped intracranial aneurysms have residual necks? Neurosurgery 46:1294–1298PubMedCrossRef

17.

Malisch TW, Guglielmi G, Vinuela F, Duckwiler GR, Gobin YP, Martin NA, Frazee JG (1997) Intracranial aneurysms treated with the Guglielmi detachable coil: midterm clinical results in a consecutive series of 100 patients. J Neurosurg 87:176–183PubMed

18.

Murayama Y, Vinuela F, Duckwiler GR, Gobin YP, Guglielmi G (1999) Embolization of incidental cerebral aneurysms by using the Guglielmi detachable coil system. J Neurosurg 90:207–214PubMed

19.

Sasaki T, Takeshima T, Tominaga M, Hashimoto H, Kawagichi S (1994) Recurrence of ICA-PCoA aneurysms after neck clipping. J Neurosurg 80:58–63CrossRef

20.

Ebina K, Suzuki M, Andoh A (1982) Recurrence of cerebral aneurysm after initial neck clipping. Neurosurgery 11:764–768PubMedCrossRef

21.

Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P; 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

22.

Gobin Y, Vinuela F, Gurian J, Guglielmi G, Duckwiler GR, Massoud TF, Martin NA (1996) Treatment of large and giant fusiform intracranial aneurysms with Guglielmi detachable coils. J Neurosurg 84:55–56PubMed

23.

Vinuela F, Duckwiler G, Mawad M (1997) Guglielmi detachable coil embolization of acute intracranial aneurysm: perioperative anatomical and clinical outcome in 403 patients. J Neurosurg 86:475–482PubMed

24.

Sluzewski M, Brilstra EH, van Rooij WJ, Wijnalda D, Tulleken CA, Rinkel GJ (2001) Bilateral vertebral artery balloon occlusion for giant vertebrobasilar aneurysms. Neuroradiology 43:336–341PubMedCrossRef

25.

Moret J, Cognard C, Weill A, Castaings L, Rey A (1997) The “remodelling technique” in the treatment of wide neck intracranial aneurysms. Interv Neuroradiol 3:21–35

26.

Sluzewski M, van Rooij WJ, Slob MJ, Bescos JO, Slump CH, Wijnalda D (2004) Relation between aneurysm volume, packing, and compaction in 145 cerebral aneurysms treated with coils. Radiology 231:653–658PubMedCrossRef

Title: Recanalization after endovascular treatment of intracerebral aneurysms
Authors: Iris Q. Grunwald
Panagiotis Papanagiotou
Tobias Struffert
Maria Politi
Christoph Krick
Gökmen Gül
Wolfgang Reith
Publication date: 01-01-2007
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 1/2007
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-006-0153-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Recanalization after endovascular treatment of intracerebral aneurysms

Abstract

Introduction

Method

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Method

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2007

European Society of Neuroradiology (ESNR)

Neuroradiological findings in vascular dementia

Karthikeyan D: Computed aided tomography case histories: brain

A 3 T event-related functional magnetic resonance imaging (fMRI) study of primary and secondary gustatory cortex localization using natural tastants

Miliary brain metastases from adenocarcinoma of the lung: MR imaging findings with clinical and post-mortem histopathologic correlation

Placement of a Neuroform2 stent into the parent vessel by navigating it along the inner wall of the aneurysm sac