The mid-long term follow-up of endovascular embolization treatment of intracranial aneurysms

Abstract

Objective To observe the mid-long term follow-up results of endovascular embolization treatment of intracranial aneurysms and to investigate the factors related to post-operative recurrence. Methods A total of 69 patients (80 aneurysms) were angiographically followed up by DSA over 18 months who were admitted to Department of Interventional Radiology, Huashan Hospital Affiliated to Fudan University, between June 2006 and August 2015 and enrolled in this retrospective study. All those patients underwent endovascular embolization treatment and studied for clinical prognosis and related factors of the recurrence. Results The follow-up period lasted 18-133 months with an average of 39.0±22.6 months. Out of 69 patients, 65 (94.2%) reported good outcomes with modified Rankin scale score < 2. There was no death in this series. Out of 80 aneurysms, 21(26.3%) had recurrence. Univariate analysis demonstrated that the recurrence rate was the highest (83.3%, 5/6) in the giant aneurysm group, the lowest (16.7%, 9/54)in the small aneurysm group, and 35.0%(7/20) in the large aneurysm group. The difference was statistically significant (P=0.002). Incomplete embolization group had higher recurrence rate than complete embolization group [58.8% (10/17) vs. 17.5% (11/63), P=0.001]. Recurrence rate of wide-necked aneurysms was higher than narrow-necked ones [36.2% (17/47) vs. 12.1%(4/33), P=0.032]. However, the location and treatment approach of aneurysms seemed to have little effect on the recurrence. Multivariate regression analysis suggested that the aneurysm size was the independent risk factor of recurrence (OR=3.828, 95%CI: 1.674-8.754, P<0.001). Conclusions The overall clinical effects of endovascular embolization treatment on intracranial aneurysms seem to be satisfactory. The aneurysm size was the independent risk factor of recurrence. The shape of aneurysm neck and extent of embolization may affect the recurrence of aneurysm. Key words: Intracranial aneurysm; Embolization, therapeutic; Recurrence; Treatment outcome; Follow-up studies