Follow-Up Outcomes After Re-Embolization for Recanalized Aneurysms After Initial Coiling: Further Recurrence Rates and Related Risk Factors

Jeongjun Lee; Jeong Wook Lim; Young Dae Cho

doi:10.1016/j.wneu.2018.03.017

Follow-Up Outcomes After Re-Embolization for Recanalized Aneurysms After Initial Coiling: Further Recurrence Rates and Related Risk Factors

Jeongjun Lee, Jeong Wook Lim, Young Dae Cho

Department of Medicine

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Background: Although it is well known that coiled aneurysms can recanalize over time, long-term outcomes of re-embolization for recurred aneurysms have not been adequately investigated. We studied the retreatment outcomes of re-embolized aneurysms during follow-up monitoring and assessed the risk factors related to further recanalization. Methods: A total of 129 patients with 133 aneurysms were retrospectively reviewed. Each aneurysm was subjected to re-embolization because of major recanalization after initial coil embolization and underwent midterm and extended monitoring after retreatment. Cumulative medical records and radiologic data were assessed. Repeat recurrence rates and related risk factors were assessed by binary logistic regression analysis. Results: A total of 47 aneurysms (35.3%) showed re-recanalization at 6 months after re-embolization, with 17 and 30 instances of minor and major recanalization, respectively. Multivariate analysis indicated that posterior circulation (hazard ratio [HR], 6.129; P = 0.010), large aneurysm (>7 mm) (HR, 13.598; P < 0.001), and incomplete occlusion at the second coiling (HR, 9.975; P = 0.001) were significant factors for repeat recanalization. Of 86 aneurysms showing complete occlusion at the midterm, 76 were further evaluated (≥12 months), showing 18 aneurysms (23.7%) of delayed re-recanalization during a follow-up of 230.1 aneurysm-years. Of 15 aneurysms with minor recanalization at 6 months, 6 (40.0%) progressed to major recanalization during a follow-up of 44.0 aneurysm-years. Conclusions: Most re-coiled aneurysms (64.7%) showed complete occlusion at the 6-month follow-up. However, posterior circulation, large aneurysm (>7 mm), and incomplete occlusion at the second coiling were risks for further recanalization. The midterm and delayed re-recanalization rates of the re-embolized aneurysms seem to be higher than those of the initial aneurysms.

Original language	English
Pages (from-to)	e508-e517
Journal	World Neurosurgery
Volume	114
DOIs	https://doi.org/10.1016/j.wneu.2018.03.017
State	Published - Jun 2018

Keywords

Aneurysm
Coil
Embolization
Recanalization
Recur

Access to Document

10.1016/j.wneu.2018.03.017

Cite this

@article{e3493ba473164ce1b21ff7962ceb0f36,

title = "Follow-Up Outcomes After Re-Embolization for Recanalized Aneurysms After Initial Coiling: Further Recurrence Rates and Related Risk Factors",

abstract = "Background: Although it is well known that coiled aneurysms can recanalize over time, long-term outcomes of re-embolization for recurred aneurysms have not been adequately investigated. We studied the retreatment outcomes of re-embolized aneurysms during follow-up monitoring and assessed the risk factors related to further recanalization. Methods: A total of 129 patients with 133 aneurysms were retrospectively reviewed. Each aneurysm was subjected to re-embolization because of major recanalization after initial coil embolization and underwent midterm and extended monitoring after retreatment. Cumulative medical records and radiologic data were assessed. Repeat recurrence rates and related risk factors were assessed by binary logistic regression analysis. Results: A total of 47 aneurysms (35.3%) showed re-recanalization at 6 months after re-embolization, with 17 and 30 instances of minor and major recanalization, respectively. Multivariate analysis indicated that posterior circulation (hazard ratio [HR], 6.129; P = 0.010), large aneurysm (>7 mm) (HR, 13.598; P < 0.001), and incomplete occlusion at the second coiling (HR, 9.975; P = 0.001) were significant factors for repeat recanalization. Of 86 aneurysms showing complete occlusion at the midterm, 76 were further evaluated (≥12 months), showing 18 aneurysms (23.7%) of delayed re-recanalization during a follow-up of 230.1 aneurysm-years. Of 15 aneurysms with minor recanalization at 6 months, 6 (40.0%) progressed to major recanalization during a follow-up of 44.0 aneurysm-years. Conclusions: Most re-coiled aneurysms (64.7%) showed complete occlusion at the 6-month follow-up. However, posterior circulation, large aneurysm (>7 mm), and incomplete occlusion at the second coiling were risks for further recanalization. The midterm and delayed re-recanalization rates of the re-embolized aneurysms seem to be higher than those of the initial aneurysms.",

keywords = "Aneurysm, Coil, Embolization, Recanalization, Recur",

author = "Jeongjun Lee and Lim, {Jeong Wook} and Cho, {Young Dae}",

note = "Publisher Copyright: {\textcopyright} 2018 Elsevier Inc.",

year = "2018",

month = jun,

doi = "10.1016/j.wneu.2018.03.017",

language = "English",

volume = "114",

pages = "e508--e517",

journal = "World Neurosurgery",

issn = "1878-8750",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Follow-Up Outcomes After Re-Embolization for Recanalized Aneurysms After Initial Coiling

T2 - Further Recurrence Rates and Related Risk Factors

AU - Lee, Jeongjun

AU - Lim, Jeong Wook

AU - Cho, Young Dae

PY - 2018/6

Y1 - 2018/6

N2 - Background: Although it is well known that coiled aneurysms can recanalize over time, long-term outcomes of re-embolization for recurred aneurysms have not been adequately investigated. We studied the retreatment outcomes of re-embolized aneurysms during follow-up monitoring and assessed the risk factors related to further recanalization. Methods: A total of 129 patients with 133 aneurysms were retrospectively reviewed. Each aneurysm was subjected to re-embolization because of major recanalization after initial coil embolization and underwent midterm and extended monitoring after retreatment. Cumulative medical records and radiologic data were assessed. Repeat recurrence rates and related risk factors were assessed by binary logistic regression analysis. Results: A total of 47 aneurysms (35.3%) showed re-recanalization at 6 months after re-embolization, with 17 and 30 instances of minor and major recanalization, respectively. Multivariate analysis indicated that posterior circulation (hazard ratio [HR], 6.129; P = 0.010), large aneurysm (>7 mm) (HR, 13.598; P < 0.001), and incomplete occlusion at the second coiling (HR, 9.975; P = 0.001) were significant factors for repeat recanalization. Of 86 aneurysms showing complete occlusion at the midterm, 76 were further evaluated (≥12 months), showing 18 aneurysms (23.7%) of delayed re-recanalization during a follow-up of 230.1 aneurysm-years. Of 15 aneurysms with minor recanalization at 6 months, 6 (40.0%) progressed to major recanalization during a follow-up of 44.0 aneurysm-years. Conclusions: Most re-coiled aneurysms (64.7%) showed complete occlusion at the 6-month follow-up. However, posterior circulation, large aneurysm (>7 mm), and incomplete occlusion at the second coiling were risks for further recanalization. The midterm and delayed re-recanalization rates of the re-embolized aneurysms seem to be higher than those of the initial aneurysms.

AB - Background: Although it is well known that coiled aneurysms can recanalize over time, long-term outcomes of re-embolization for recurred aneurysms have not been adequately investigated. We studied the retreatment outcomes of re-embolized aneurysms during follow-up monitoring and assessed the risk factors related to further recanalization. Methods: A total of 129 patients with 133 aneurysms were retrospectively reviewed. Each aneurysm was subjected to re-embolization because of major recanalization after initial coil embolization and underwent midterm and extended monitoring after retreatment. Cumulative medical records and radiologic data were assessed. Repeat recurrence rates and related risk factors were assessed by binary logistic regression analysis. Results: A total of 47 aneurysms (35.3%) showed re-recanalization at 6 months after re-embolization, with 17 and 30 instances of minor and major recanalization, respectively. Multivariate analysis indicated that posterior circulation (hazard ratio [HR], 6.129; P = 0.010), large aneurysm (>7 mm) (HR, 13.598; P < 0.001), and incomplete occlusion at the second coiling (HR, 9.975; P = 0.001) were significant factors for repeat recanalization. Of 86 aneurysms showing complete occlusion at the midterm, 76 were further evaluated (≥12 months), showing 18 aneurysms (23.7%) of delayed re-recanalization during a follow-up of 230.1 aneurysm-years. Of 15 aneurysms with minor recanalization at 6 months, 6 (40.0%) progressed to major recanalization during a follow-up of 44.0 aneurysm-years. Conclusions: Most re-coiled aneurysms (64.7%) showed complete occlusion at the 6-month follow-up. However, posterior circulation, large aneurysm (>7 mm), and incomplete occlusion at the second coiling were risks for further recanalization. The midterm and delayed re-recanalization rates of the re-embolized aneurysms seem to be higher than those of the initial aneurysms.

KW - Aneurysm

KW - Coil

KW - Embolization

KW - Recanalization

KW - Recur

UR - http://www.scopus.com/inward/record.url?scp=85045019691&partnerID=8YFLogxK

U2 - 10.1016/j.wneu.2018.03.017

DO - 10.1016/j.wneu.2018.03.017

M3 - Article

C2 - 29530696

AN - SCOPUS:85045019691

SN - 1878-8750

VL - 114

SP - e508-e517

JO - World Neurosurgery

JF - World Neurosurgery

ER -

Follow-Up Outcomes After Re-Embolization for Recanalized Aneurysms After Initial Coiling: Further Recurrence Rates and Related Risk Factors

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this