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08.01.2016 | Neuro

Extended monitoring of coiled aneurysms completely occluded at 6-month follow-up: late recanalization rate and related risk factors

verfasst von: Jin Pyeong Jeon, Young Dae Cho, Jong Kook Rhim, Dong Hyun Yoo, Hyun-Seung Kang, Jeong Eun Kim, Won-sang Cho, Moon Hee Han

Erschienen in: European Radiology | Ausgabe 10/2016

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Abstract

Objectives

To estimate long-term durability in coiled aneurysms completely occluded at 6-month follow-up imaging, focusing on late recanalization rate and the risk factors involved.

Methods

A cohort of 620 patients harbouring 698 completely occluded coiled aneurysms at 6-month follow-up was subjected to extended monitoring (mean, 24.5 ± 7.9 months). Cumulative recanalization rate and related risk factors were analysed using Cox proportional hazards regression and Kaplan–Meier product-limit estimator.

Results

Forty-three aneurysms (6.2 %) occluded completely at 6-months displayed recanalization (3.02 % per aneurysm-year) during continued surveillance (1425.5 aneurysm-years), with 26 (60.5 %) surfacing in another 6 months, 15 (34.9 %) within 18 months and 2 (4.6 %) within 30 months. Cumulative survival rates without recanalization were significantly lower in subjects with aneurysms >7 mm (p = 0.014), with bifurcation aneurysms (p = 0.009) and with subarachnoid haemorrhage (SAH) at presentation (p < 0.001). Multivariate analysis indicated that aneurysms >7 mm (HR = 2.37, p = 0.02) and bifurcation aneurysms (HR = 2.70, p = 0.03) were significant factors in late recanalization, whereas a link with SAH at presentation was marginal (HR = 1.92, p = 0.06) and stent placement fell short of statistical significance (HR = 0.47; p = 0.12).

Conclusion

Most (93.8 %) coiled aneurysms showing complete occlusion at 6 months post-procedure were stable in long-term monitoring. However, aneurysms >7 mm and bifurcation aneurysms were predisposed to late recanalization.

Key Points

• Most coiled aneurysms showing complete occlusion at 6 months were stable.

• Forty-three aneurysms (6.2 %) occluded completely at 6-month follow-up displayed late recanalization.

• Late recanalization rate was 3.02 % per aneurysm-year during follow-up of 1425.5 aneurysm-years.

• Aneurysms over 7 mm and bifurcation aneurysms were predisposed to late recanalization.

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Titel: Extended monitoring of coiled aneurysms completely occluded at 6-month follow-up: late recanalization rate and related risk factors
verfasst von: Jin Pyeong Jeon
Young Dae Cho
Jong Kook Rhim
Dong Hyun Yoo
Hyun-Seung Kang
Jeong Eun Kim
Won-sang Cho
Moon Hee Han
Publikationsdatum: 08.01.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2016
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4176-3

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Extended monitoring of coiled aneurysms completely occluded at 6-month follow-up: late recanalization rate and related risk factors