TY - JOUR
T1 - Risk factor analysis of recanalization timing in coiled aneurysms
T2 - Early versus late recanalization
AU - Jeon, J. P.
AU - Cho, Y. D.
AU - Yoo, D. H.
AU - Moon, J.
AU - Lee, J.
AU - Cho, W. S.
AU - Kang, H. S.
AU - Kim, J. E.
AU - Han, M. H.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - BACKGROUND AND PURPOSE: Long-term documentation of anatomic and angiographic characteristics pertaining to the timing of recanalization in coiled aneurysms has been insufficient. Our intent was to analyze and compare early and late-phase recanalization after coiling, identifying respective risk factors. MATERIALS AND METHODS: A total of 870 coiled saccular aneurysms were monitored for extended periods (mean, 30.8±8.3 months). Medical records and radiologic data were also reviewed, stratifying patients as either early (n = 128) or late (n = 52) recanalization or as complete occlusion (n = 690). Early recanalization was equated with confirmed recanalization within 6 months after the procedure, whereas late recanalization was defined as verifiable recanalization after imaging confirmation of complete occlusion at 6 months. A multinomial regression model served to assess potential risk factors, the reference point being early recanalization. RESULTS: Posterior circulation (P=.009), subarachnoid hemorrhage at presentation (P=.011), second attempt for recanalized aneurysm (P < .001), and aneurysm size >7 mm (P < .001) emerged as variables significantly linked with early recanalization (versus complete occlusion). Late (versus early) recanalization corresponded with aneurysms ≤7 mm (P = .013), and in a separate subanalysis of lesions ≤7 mm, aneurysms 4-7 mm showed a significant predilection for late recanalization (P = .008). However, the propensity for complete occlusion in smaller lesions (≤7 mm) increased as the size diminished. CONCLUSIONS: Although long-term complete occlusion after coiling was more likely in aneurysms ≤7 mm, such lesions were more prone to late (versus early) recanalization, particularly those of 4-7 mm in size. Long-term follow-up imaging is thus appropriate in aneurysms >4 mm to detect late recanalization of those formerly demonstrating complete occlusion.
AB - BACKGROUND AND PURPOSE: Long-term documentation of anatomic and angiographic characteristics pertaining to the timing of recanalization in coiled aneurysms has been insufficient. Our intent was to analyze and compare early and late-phase recanalization after coiling, identifying respective risk factors. MATERIALS AND METHODS: A total of 870 coiled saccular aneurysms were monitored for extended periods (mean, 30.8±8.3 months). Medical records and radiologic data were also reviewed, stratifying patients as either early (n = 128) or late (n = 52) recanalization or as complete occlusion (n = 690). Early recanalization was equated with confirmed recanalization within 6 months after the procedure, whereas late recanalization was defined as verifiable recanalization after imaging confirmation of complete occlusion at 6 months. A multinomial regression model served to assess potential risk factors, the reference point being early recanalization. RESULTS: Posterior circulation (P=.009), subarachnoid hemorrhage at presentation (P=.011), second attempt for recanalized aneurysm (P < .001), and aneurysm size >7 mm (P < .001) emerged as variables significantly linked with early recanalization (versus complete occlusion). Late (versus early) recanalization corresponded with aneurysms ≤7 mm (P = .013), and in a separate subanalysis of lesions ≤7 mm, aneurysms 4-7 mm showed a significant predilection for late recanalization (P = .008). However, the propensity for complete occlusion in smaller lesions (≤7 mm) increased as the size diminished. CONCLUSIONS: Although long-term complete occlusion after coiling was more likely in aneurysms ≤7 mm, such lesions were more prone to late (versus early) recanalization, particularly those of 4-7 mm in size. Long-term follow-up imaging is thus appropriate in aneurysms >4 mm to detect late recanalization of those formerly demonstrating complete occlusion.
UR - http://www.scopus.com/inward/record.url?scp=85029230916&partnerID=8YFLogxK
U2 - 10.3174/ajnr.A5267
DO - 10.3174/ajnr.A5267
M3 - Article
C2 - 28619836
AN - SCOPUS:85029230916
SN - 0195-6108
VL - 38
SP - 1765
EP - 1770
JO - American Journal of Neuroradiology
JF - American Journal of Neuroradiology
IS - 9
ER -