Incidence and risk factors of recurrence after endovascular treatment of vertebrobasilar dissecting aneurysms

Abstract

Objective: To evaluate the incidence and risk factors of recurrence after endovascular treatment of vertebrobasilar dissecting aneurysms (VBDAs). Methods: Retrospective analysis was used for the clinical information of 40 cases of vertebrobasilar dissecting aneurysms treated with endovascular methods in our department between January 2007 and December 2015.According to whether recurrence occurred, the patients were divided into recurrence group (10 patients) and non-recurrence group (30 patients). The data of the patients' age, sex, hypertension history, smoking history, aneurismal size, presenting symptoms, degree of embolization, GCS scores, aneurismal localization and treatment methods were analyzed to evaluate the risk factors for recurrence after endovascular treatment. Results: There were 40 patients performed long-term angiographic follow-up.The recurrence rate after endovascular treatment was 25.0% (10/40) in the present study, and they all occurred in reconstructive group.Among the patients who underwent stent-assisted coil embolization, recurrence in aneurismal body occurred in 6 patients, and recurrence in aneurismal neck 3 cases. In these cases, 7 recurrences occurred with complete embolization, and 2 recurrences occurred with partial embolization.Recurrence occurred in 1 case that underwent single stent placement.The incidence of recurrence in reconstructive group was higher than that in destructive group (33.3% vs 0.0) with significant difference. Conclusions: The recurrence rate was high in VBDAs treated with endovascular methods.The only independent risk factor for recurrence was reconstructive methods and that suggests the necessity of long-term angiographic follow-up.