Mid-long term follow-up of endovascularly treated intracranial aneurysms

Abstract

Aim: Surgical clipping is the gold standard treatment method for the treatment of intracranial aneurysms, but endovascular therapy has become an alternative to surgical treatment for the last 30 years. In aneurysms treated with the endovascular method, recurrence may develop due to the mechanic failure of coil. The purpose of this study is; endovascularly-treated aneurysms follow up as planed. Material and Method: The study included 149 aneurysms of 130 patients treated and controlled endovascularly between January 2004 and December 2013. 72 of the patients were women, and 58 were males. Patients were between 13 and 81 years of age and the mean age was 50.9. Patients were followed for 6 to 84 months by magnetic resonance angiography and digital subtraction angiography. Morphological results were evaluated according to the Raymond classification. Raymond 1 (total occlusion), Raymond 2 (filling of the aneurysm neck) and Raymond 3 (residual aneurysm). Results: Raymond class 1 occlusion was obtained in 116 aneurysms treated with endovascular treatment (77.9%), Raymond class 2 in 16 aneurysms (10.9%) and Raymond class 3 occlusion in 17 aneurysms (11.4%). The total recanalization rate was 22.1%. Of 33 patients with Raymond class 2 and 3, 17 were diagnosed at the 6th month. The remaining 14 patients were diagnosed at the 1st year controls and 2 patients at the 2nd year controls. Of the 33 aneurysms with remnant-recurrence, 5 were giant aneurysms (> 25 mm), 14 were large aneurysms (10-25 mm), and 14 were small aneurysms (<10 mm). Conclusion: It is important to assess the stability of follow-up treatment after endovascular treatment and to detect early of recurrence. Many studies have reported that at least two controls should be performed within the first year after endovascular treatment. Long term follow-up is an appropriate choice to perform with magnetic resonance angiography.