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Determination of Aneurysm Volume Critical for Stability After Coil Embolization: A Retrospective Study of 3530 Aneurysms.

Authors
  • Choi, Hyun Ho1
  • Lee, Su Hwan2
  • Yeon, Eung Koo3
  • Yoo, Dong Hyun3
  • Cho, Young Dae3
  • Cho, Won-Sang2
  • Kim, Jeong Eun2
  • Son, Young-Je4
  • Han, Moon Hee5
  • Kang, Hyun-Seung6
  • 1 Department of Neurosurgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea. , (North Korea)
  • 2 Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. , (North Korea)
  • 3 Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. , (North Korea)
  • 4 Department of Neurosurgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea. , (North Korea)
  • 5 Department of Neurosurgery, Korea Veterans Hospital Medical Center, Seoul, Korea. , (North Korea)
  • 6 Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. Electronic address: [email protected] , (North Korea)
Type
Published Article
Journal
World neurosurgery
Publication Date
Dec 01, 2019
Volume
132
Identifiers
DOI: 10.1016/j.wneu.2019.08.020
PMID: 31415892
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Recurrence is one of the concerns even after successful endovascular treatment of intracranial aneurysms. We sought to determine the critical aneurysm volume and risk factors related to aneurysmal stability in patients undergoing coil embolization of intracranial aneurysms. Aneurysm volume and follow-up imaging data were retrieved in 3042 patients with 3530 aneurysms who were treated with endovascular coil embolization from January 2006 to October 2016. We analyzed the anatomic outcome in relation to aneurysm volume and determined the critical aneurysm volume favoring coil embolization. Recanalization rates were 2.8%, 6.3%, 19.4%, and 67.4% in each group with aneurysm volume of <10, 10-100, 100-1000, and >1000 mm3, respectively. When we investigated the 100-1000 mm3 group, the recanalization rate remarkably increased at 500 mm3 (16.4% vs. 57.5%, P < 0.0001; odds ratio [OR], 6.968; 95% confidence interval [CI], 3.562-13.631). In the entire cohort, recanalization rates were significantly different between aneurysm volume of <500 and >500 mm3 (7.2% vs. 62.9%, respectively; P < 0.0001; OR, 21.848; 95% CI, 13.944-34.235). In aneurysm volumes of >500 mm3, the location was a significant prognostic factor for long-term stability (posterior circulation vs. anterior circulation; OR, 4.737; 95% CI, 1.275-17.602; P = 0.020). In our series of cerebral aneurysms treated with coil embolization, 500 mm3 was found to be the critical volume determining stability after coil embolization. Large volume aneurysms in the posterior circulation were especially prone to recanalization after coiling. Copyright © 2019 Elsevier Inc. All rights reserved.

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