Does Systemic Hypertension Impact Recanalization of Coiled Aneurysms?

Su Hwan Lee, Young Dae Cho, Jong Hyeon Mun, Dong Hyun Yoo, Eung Koo Yeon, Hyun Seung Kang, Jeong Eun Kim, Won Sang Cho, Moon Hee Han

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Purpose: It is well known that hypertension is a significant factor in the formation, growth, and rupture of aneurysms and recanalization of coiled aneurysms is affected by hemodynamic stress. At present, however, the impact of hypertension on recanalization of coiled aneurysms has not been adequately investigated. This study examined the relation between hypertension and subsequent outcomes of coiled aneurysms, using a matched patient analysis. Methods: A total of 715 subjects undergoing coil embolization of intracranial aneurysms between 2011 and 2013 were selected for study. Time-of-flight magnetic resonance or conventional angiography was used (singly or together) to gauge degrees of occlusion after coiling, applying the Raymond classification in grading recanalization. Patients with hypertension were grouped as controlled or uncontrolled, based on blood pressure readings at outpatient clinics. Hypertensive and non-hypertensive subjects were matched (1:1) for several relevant variables. Results: Overall, 484 patients (67.7%) were hypertensive (controlled 338; uncontrolled 146). During the follow-up period (28.6 ± 9.7 months), 129 aneurysms (18.0%) displayed recanalization (minor 58; major 71). Patient age, concomitant diabetes, hyperlipidemia, aneurysm size, neck size, depth-to-neck ratio, and aneurysm type differed significantly in hypertensive and non-hypertensive groups; however, group incidences of cumulative recanalization were similar (p = 0.297). After 1:1 matching the cumulative recanalization rate (13.5%) in hypertensive and non-hypertensive counterparts (14.3%) again proved similar (p = 0.578). In the hypertensive group, in addition, recanalization showed no relation to controlled and uncontrolled subgroup (odds ratio, OR = 1.000, p > 0.999). Conclusion: Unlike other aspects of evolving aneurysms (e.g. formation, growth, or rupture), recanalization of coiled aneurysms seems to be unaffected by systemic hypertension.

Original languageEnglish
Pages (from-to)117-124
Number of pages8
JournalClinical Neuroradiology
Volume31
Issue number1
DOIs
StatePublished - Mar 2021

Keywords

  • Aneurysm
  • Coil embolization
  • Hypertension
  • Recanalization
  • Recurrence

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