Predictors of recanalization after endovascular treatment of posterior circulation aneurysms
Journal Title: Polish Journal of Surgery - Year 2017, Vol 89, Issue 6
Abstract
<b>Introduction.</b> Posterior circulation aneurysms account for approximately 30% of all intracranial aneurysms, and their rupture often causes aneurysmal subarachnoid hemorrhage (aSAH). Because surgical treatment of posterior circulation aneurysms is difficult, endovascular treatment is commonly indicated. However, simple coil embolization is associated with a high rate of recanalization. Our goal was to investigate morphometric aneurysmal features assessed on pre-embolization computed tomography angiography (CTA) as predictors of recanalization in patients with posterior circulation aneurysms. <b>Material and Methods.</b> We retrospectively analyzed data of 24 patients who underwent coil embolization due to rupture of saccular posterior circulation aneurysms. The morphometric features of aneurysms were measured based on pre-embolization 3D-CTA-aneurysm models, and aneurysmal size and volume were measured on digital subtraction angiography (DSA) images. The effectiveness of initial endovascular treatment was determined visually with the modified Raymond Roy classification directly after embolization and on follow-up DSAs. Recanalization was diagnosed when, compared to the primary embolization aneurysm appearance, compaction and filling of the aneurysm occurred. Statistical analysis was performed with Statistica 13.1 software. <b>Results.</b> Higher maximal aneurysm height perpendicular to the aneurysmal neck was associated with a greater aneurysm recanalization risk (12.12±5.13mm vs. 7.41±3.97mm, p=0.039), and this relationship remained significant after adjustment for patient’s age, sex and aneurysm localization (OR=1.26, 95%CI: 1.01-1.60, p=0.047). Maximal aneurysm height perpendicular to the aneurysmal neck distinguished well between recanalized and non-recanalized aneurysms (AUC=0.755, 95%CI: 0.521- 0.989, p=0.033). <b>Conclusions</b>. Predictors of aneurysm recanalization can help choose best endovascular treatment strategies, which could reduce complication rates.<br/><br/>
Authors and Affiliations
Karol Wiśniewski, Bartłomiej Tomasik, Ernest J. Bobeff, Ludomir Stefańczyk, Dariusz J. Jaskólski
Keywords
Related Articles
- EP ID EP242378
- DOI 10.5604/01.3001.0010.6734
- Views 99
- Downloads 0
The Potential of Bacteriophages in the Treatment of Burn Wounds
Posterior component separation – first report from Poland on new surgical technique used in major abdominal hernia treatment
-
Consent for surgery in view of an ambigious court decision – case report
Guardianship courts seem to issue decisions in case of the need to obtain consent for surgery, amongst other things, when the patient is unable to consciously express written consent, and at the same time does not have a...
Infections in Notes
Incidental diagnosis of the tall-cell variant of the papillary microcarcinoma of the thyroid gland requires completion lymphadenectomy: case report
Papillary thyroid carcinoma is the most common neoplasm of the thyroid gland which is usually associated with a very good prognosis. The aim of this case report is to present the disease course of a rare tumor of the thy...