Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Angiographic Results of Wide-Necked Intracranial Aneurysms Treated with Coil Embolization : A Single Center Experience

  • Song, Joon Ho (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Chang, In Bok (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Ahn, Jun Hyong (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Kim, Ji Hee (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Oh, Jae Keun (Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University) ;
  • Cho, Byung Moon (Department of Neurosurgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University)
  • Received : 2014.04.11
  • Accepted : 2015.01.08
  • Published : 2015.04.28
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Abstract

Objective : Endovascular treatment of wide-necked intracranial aneurysms is a challenge and the durability and the safety of these treated aneurysms remain unknown. The aim of this study was to evaluate the clinical and long-term angiographic results of wide-necked intracranial aneurysms treated with coil embolization. Methods : Between January 2002 and December 2012, 53 wide-necked aneurysms treated with coil embolization were selected. Forty were female, and 13 were male. Twenty eight (52.8%) were ruptured aneurysms, and 25 (47.2%) were unruptured aneurysms. The patents' medical and radiological records were reviewed retrospectively. Results : Of the 53 aneurysms, coiling alone was employed in 45 (84.9%) and stent-assisted coiling was done in 8 (15.1%). The initial angiographic results revealed Raymond class 1 (complete occlusion) in 30 (56.6%) cases, Raymond class 2 (residual neck) in 18 (34.0%) cases, and Raymond class 3 (residual sac) in 5 (9.4%) cases. The mean angiographic follow-up period was 37.9 months (12-120 months). At the last angiographies, Raymond class 1 was seen in 26 (49.1%) cases, Raymond class 2 in 16 (30.2%), and Raymond class 3 in 11 (20.8%). Angiographic recurrence occurred in 22 (41.5%) patients, with minor recurrence in 7 (13.2%) cases and major recurrence in 15 (28.3%). Retreatment was performed in 8 cases (15.1%). A suboptimal result on the initial angiography was a significant predictor of recurrence in this study (p=0.03). Conclusion : The predictor of recurrence in wide-necked aneurysms is a suboptimal result on the initial angiography. Long-term angiographic follow-up is recommended in wide-necked aneurysms.

Keywords

References

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