Endovascular treatment of largely thrombosed saccular aneurysms: follow-up results in ten patients

Abstract

Partially thrombosed aneurysms are known to be vulnerable to recanalization after coiling. However, concerns about the extent or age of intra-aneurysmal thrombosis have not been addressed in relation to the recanalization. We evaluated the follow-up results in ten patients with largely thrombosed (>or=80% in volume) saccular aneurysms treated by coil embolization. Medical records of ten patients with largely thrombosed saccular aneurysms treated by coil embolization were retrospectively reviewed. The aneurysm size measured on MR/CT images and angiograms was 25.6 +/- 8.1 and 8.7 +/- 2.9 mm, respectively. None of the aneurysms were ruptured, and four were symptomatic due to mass effect. Angiographic occlusion rates after coiling were total occlusion in two, neck remnant in seven, and residual aneurysm in one. Follow-up anatomical and clinical outcomes were assessed. No permanent complication developed after procedures. Recanalization occurred in three (30%) during a mean follow-up period of 17.4 +/- 16.3 months. Only aneurysm neck size (P = 0.03) was found to be significantly associated with recanalization. All three patients with recanalization underwent repeat embolization. The symptoms related to mass effects were improved in three (75%) after coiling. After treatment, a bleeding episode did not occur in any of ten patients. In a series of ten patients with largely thrombosed aneurysms, this study showed that endovascular treatment of the aneurysms was a safe procedure with a 30% rate of midterm recanalization. These results will provide preliminary information and a meaningful basis for further study on treatment outcomes of this specific subgroup of patients.