ABSTRACT
Objective There are limited data about the rate of
recanalization following complete coil occlusion. Long
term clinical and angiographic outcome of completely
occluded intracranial aneurysms (IAs) by the
endovascular approach are presented.
Methods Over the course of 4 years, patients with IAs
which were completely occluded by coiling at our
institution were reviewed. Clinical and angiographic data
were analyzed. The patients were clinically assessed
using the Glasgow Outcome Scale (GOS). Follow-up
angiographic findings were categorized as: stable
aneurysm with no recanalization, recanalization with
a neck remnant and recanalization with a body remnant.
Results 83 aneurysms were identified in 74 patients
(15 men and 59 women, average age 52.4 years) with
complete occlusion post intervention. Treatment by
coiling only was used in 73 aneurysms while stent
assisted coiling was used in 10 cases. At the last
angiographic follow-up (mean 16.3 months), 20 of the 83
aneurysms demonstrated various degrees of
recanalization of which five had neck remnants and 15
had body remnants. The recanalization rate was
significantly higher in large aneurysms (57%) compared
with small aneurysms (14%). Clinically, 65 of the 74
patients showed good recovery (GOS score 5), eight had
moderate disability (GOS score 4) and one was severely
disabled (GOS score 3).
Conclusion Complete endovascular occlusion of IA is
certainly effective in preventing aneurysmal bleeding.
However, recanalization rate, despite being lower when
compared with subtotal occlusion, remains an issue.
Longer follow-up is required. |
