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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:1916-1920, September 2005
© 2005 American Society of Neuroradiology

INTERVENTIONAL

Absent Relationship between the Coil-Embolization Ratio in Small Aneurysms Treated with a Single Detachable Coil and Outcomes

James K. Goddard^a, Christopher J. Moran^a, DeWitte T. Cross, III^a and Colin P. Derdeyn^a

^a From the Neuroradiology Section (Interventional Neuroradiology), Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO

Address correspondence to Christopher J. Moran, MD, Neuroradiology Section, Mallinckrodt Institute of Radiology, Washington University School of Medicine, Campus Box 8131, 510 South Kingshighway Boulevard, St. Louis, MO 63110-1016

BACKGROUND AND PURPOSE: Although attenuated coil packing of intracranial aneurysms is an important goal of endovascular embolization, because of their small size, some aneurysms can only be treated with a single embolization coil. We retrospectively analyzed small aneurysms treated with a single Guglielmi detachable coil (GDC) to determine whether the coil-embolization ratio (CER) is predictive of embolization stability.

METHODS: The CER was determined for 25 small (<7-mm diameter) intracranial aneurysms, each treated with a single embolization coil. The largest aneurysm dimension, estimated by comparison to anatomic landmarks, was used for volume calculation based on a spherical model. Coil volumes were according to manufacturer specifications. CER was calculated by the formula (coil volume/aneurysm volume) x 100%. Embolization stability was assessed by angiographic follow-up.

RESULTS: The average CER for all aneurysms was 8.2% (SD, 6.5%; range, 0.6%–21.1%). Twelve percent of the aneurysms had a CER >20%. Follow-up angiographic assessment was conducted at an average of 30.8 months after initial treatment. Eighty-four percent of the aneurysms were obliterated. One large (6 x 10 mm) and 3 small (<1 mm) recurrences were identified. The average CER for unchanged aneurysms was 8.0% (SD, 5.9%) and for the recurrent aneurysms was 8.8% (SD, 8.7%), which was not statistically significant.

CONCLUSION: Small aneurysms treated with a single coil achieved satisfactory stability despite having a low average packing attenuation. CER was not predictive of recurrence in small intracranial aneurysms treated with a single detachable coil.

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