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http://dx.doi.org/10.3340/jkns.2015.57.4.250

Angiographic Results of Wide-Necked Intracranial Aneurysms Treated with Coil Embolization : A Single Center Experience  

Song, Joon Ho (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University)
Chang, In Bok (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University)
Ahn, Jun Hyong (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University)
Kim, Ji Hee (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University)
Oh, Jae Keun (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University)
Cho, Byung Moon (Department of Neurosurgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University)
Publication Information
Journal of Korean Neurosurgical Society / v.57, no.4, 2015 , pp. 250-257 More about this Journal
Abstract
Objective : Endovascular treatment of wide-necked intracranial aneurysms is a challenge and the durability and the safety of these treated aneurysms remain unknown. The aim of this study was to evaluate the clinical and long-term angiographic results of wide-necked intracranial aneurysms treated with coil embolization. Methods : Between January 2002 and December 2012, 53 wide-necked aneurysms treated with coil embolization were selected. Forty were female, and 13 were male. Twenty eight (52.8%) were ruptured aneurysms, and 25 (47.2%) were unruptured aneurysms. The patents' medical and radiological records were reviewed retrospectively. Results : Of the 53 aneurysms, coiling alone was employed in 45 (84.9%) and stent-assisted coiling was done in 8 (15.1%). The initial angiographic results revealed Raymond class 1 (complete occlusion) in 30 (56.6%) cases, Raymond class 2 (residual neck) in 18 (34.0%) cases, and Raymond class 3 (residual sac) in 5 (9.4%) cases. The mean angiographic follow-up period was 37.9 months (12-120 months). At the last angiographies, Raymond class 1 was seen in 26 (49.1%) cases, Raymond class 2 in 16 (30.2%), and Raymond class 3 in 11 (20.8%). Angiographic recurrence occurred in 22 (41.5%) patients, with minor recurrence in 7 (13.2%) cases and major recurrence in 15 (28.3%). Retreatment was performed in 8 cases (15.1%). A suboptimal result on the initial angiography was a significant predictor of recurrence in this study (p=0.03). Conclusion : The predictor of recurrence in wide-necked aneurysms is a suboptimal result on the initial angiography. Long-term angiographic follow-up is recommended in wide-necked aneurysms.
Keywords
Cerebral angiography; Intracranial aneurysm; Recurrence;
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