Long-Term Results and Follow-Up Examinations after Endovascular Embolization for Unruptured Cerebral Aneurysms.

T Murakami,T Fujinaka,T Nishida,H Nakamura,K Asai,Y Kadono,H Kishima

doi:10.3174/ajnr.a6101

Abstract

The appropriate period of follow-up examinations after endovascular embolization for cerebral aneurysms using time-of-flight MR angiography is not well-known. We retrospectively investigated long-term results after endovascular embolization for unruptured cerebral aneurysms and evaluated the periods from embolization to recanalization and retreatment. Between April 2006 and March 2011, one hundred forty-eight unruptured aneurysms were treated with endovascular coil embolization. Among them, we investigated 116 unruptured aneurysms, which were followed up for >5 years. Time-of-flight MR angiography was performed at 1 day, 3-6 months, 1 year after the procedure, and every year thereafter. The mean follow-up period was 7.0 ± 1.4 years. Recanalization was observed in 19 (16.3%) aneurysms within 2 years. Among them, retreatment for recanalization was performed in 8 (6.8%) aneurysms. No recanalization was detected in any aneurysms that had been stable in the first 2 years after embolization. A larger maximum aneurysm size was significantly correlated with recanalization (P = .019). Aneurysms in which recanalization was not observed within 2 years after endovascular coil embolization were stable during a mean follow-up of 7 years. This result may be helpful in considering the appropriate span or frequency of follow-up imaging for embolized cerebral aneurysms.

Highlights

MethodsBetween April 2006 and March 2011, one hundred forty-eight unruptured aneurysms were treated with endovascular coil embolization
BACKGROUND AND PURPOSEThe appropriate period of follow-up examinations after endovascular embolization for cerebral aneurysms using time-of-flight MR angiography is not well-known
This result may be helpful in considering the appropriate span or frequency of follow-up imaging for embolized cerebral aneurysms

Summary

Methods

Between April 2006 and March 2011, one hundred forty-eight unruptured aneurysms were treated with endovascular coil embolization. We investigated 116 unruptured aneurysms, which were followed up for Ͼ5 years. Ethics Ethics approval for the study was obtained from the Osaka University Hospital institutional review board (approval No 16490). Patient Population and Follow-Up Periods In our institution, the treatment indication for unruptured cerebral aneurysms was decided according to the Japanese Guidelines for the Management of Stroke.[12] Endovascular coil embolization or surgical neck clipping was performed with the patient’s informed consent. In case of multiple aneurysms, coil embolization was performed for any aneurysm, even if it was small, when it was technically possible. Between April 2006 and March 2011, one hundred forty-eight unruptured aneurysms in 126 patients were treated with endovascular coil embolization at Osaka University Hospital.

Results

Discussion

Conclusion