Abstract:
BACKGROUND:Although endovascular technique and related devices continue to improve, recanalization of embolized aneurysm remains a pitfall of this approach. The problem of how to treat the recanalized aneurysm needs to be addressed. OBJECTIVE:To determine the outcomes of patients undergoing repeat embolization for recanalized intracranial aneurysms and to evaluate the impact of stent implantation on subsequent recanalization. METHODS:Between September 2001 and September 2011, we performed endovascular retreatment in 162 patients with a total of 197 recanalized intracranial aneurysms. Stent implantation was performed in 68 aneurysms during the retreatment. Clinical and morphological outcomes were assessed at 6 months or more after repeat embolization. RESULTS:Procedure-related complications, including asymptomatic thromboembolism, occurred with 15 aneurysms (7.6%) without permanent neurological sequelae. Follow-up imaging of 172 aneurysms documented stable occlusion in 96 of the lesions (55.8%), minor recanalization in 17 (9.9%), and major recanalization in 59 (34.3%) during the mean follow-up period of 26.0 ± 18.0 months. In multiple logistic regression analysis, stent implantation was shown to reduce the major recanalization rate at 6 months after retreatment (odds ratio: 0.161; 95% confidence interval:, 0.038-0.670; P = .012) and thereafter (odds ratio: 0.226; 95% confidence interval: 0.088-0.581; P = .002). CONCLUSION:Stent implantation, as well as compact coil packing, at the time of repeat embolization seems beneficial in reducing rates of further recanalization.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Cho YD,Lee JY,Seo JH,Lee SJ,Kang HS,Kim JE,Son YJ,Jung KH,Kwon OK,Han MHdoi
10.1227/NEU.0b013e3182647a97subject
Has Abstractpub_date
2012-12-01 00:00:00pages
ons253-9; discussion ons259issue
2 Suppl Operativeeissn
0148-396Xissn
1524-4040pii
00006123-201212002-00008journal_volume
71pub_type
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