Clinical research of X-ray plain film assessment of recurrence after interventional treatment of intracranial aneurysms

Abstract

Objective To investigate the clinical application value of using conventional X-ray fluoroscopy follow-up after interventional treatment of intracranial aneurysms. Methods From August 2013 to June 2015, all patients with intracranial aneurysm treated with interventional therapy and followed up with digital subtraction angiography (DSA) at the Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command were analyzed retrospectively. The patients were asked to have both immediately after procedure and reexamination operation position angiograms (all patients took conventional0°/CRAN 30°andLAO 90°/0°angiograms). A total of 86 patients with 102 aneurysms met the demands. The shadowgraphs of the microcoils were collected: the immediately after procedureoperating position, reexaminationoperation position,0°/CRAN 30°, andLAO 90°/0°shadowgraphs. The coil shape documented with the corresponding projection angle were compared in the immediately after procedure and follow-up shadowgraphs and determined whether the coil shape changed or not. Whether the aneurysms recurrence or not were identified according to the DSA result of the same case. Kappa test was used to analyze the consistency. Results In 102 aneurysms using microcoil embolization, 90 coils did not have any change. DSA examination revealed no relapse. Under X-ray fluoroscopy, the coil shape did not have any change in 3 cases, but DSA revealed aneurysm recurrence. Under X-ray fluoroscopy, the coil shape changed in 9 cases, and DSA did not reveal recurrence. Using Kappa test, both methods were highly consistent (K=0.76, P<0.05). Conclusions Observing microcoil shape with X-ray fluoroscopy can well predict whether aneurysms recurrence or not. It has better clinical application value in the follow-up after intracranial aneurysm intervention. Key words: Radiography; Intracranial aneurysm; Embolism; Follow-up studies