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AJNR - American Journal of Neuroradiology

Published ahead of print on April 24, 2008
doi: 10.3174/ajnr.A1098

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American Journal of Neuroradiology 29:1401-1404, August 2008
© 2008 American Society of Neuroradiology

INTERVENTIONAL

Retreatment of Previously Embolized Cerebral Aneurysms: The Risk of Further Coil Embolization Does Not Negate the Advantage of the Initial Embolization

S.A. Renowden^a, P. Koumellis^b, V. Benes^c, W. Mukonoweshuro^d, A.J. Molyneux^a and N.S. McConachie^b

^a Department of Neuroradiology, Frenchay Hospital North Bristol NHS Trust, Bristol, UK
^b Department of Neuroradiology, Queens Medical Centre, Nottingham, UK
^c Department of Neurosurgery, Regional Hospital, Liberec, Czech Republic
^d Department of Neuroradiology, Derriford Hospital, Plymouth, UK

Please address correspondence to Panos Koumellis, MD, Department of Neuroradiology, B Floor, Queens Medical Centre, Nottingham, UK, NG7 2UH; e-mail: Panos.Koumellis{at}nuh.nhs.uk

BACKGROUND AND PURPOSE: A significant minority of aneurysms treated by endovascular means undergo additional subsequent therapy to treat aneurysm recurrence. Our study was undertaken to determine the risk of additional coil embolization of aneurysms recurring following endovascular therapy.

MATERIALS AND METHODS: Patients were identified during a 10-year period from prospectively collated data bases at 2 different neuroscience institutions. Patient outcome was obtained from the data bases or the patient's neurosurgical records. Occlusion grade was assessed at the time of treatment and at follow-up angiography as complete, near-complete, or incomplete.

RESULTS: Of a total of 1834 aneurysms in 1631 patients, 100 aneurysms in 99 patients treated between January 1996 and December 2005 required additional coiling because of an enlarging remnant and subtotal occlusion. This comprised 6% of the patients treated and 8% of the total followed. Thromboembolic events complicated 3 retreatment procedures, but all 3 patients remain independent. Ninety-five patients were followed for 8–103 months (mean, 42.3 months) by conventional or MR angiography.

CONCLUSION: Coil embolization of aneurysm recurrences has a low complication rate and leads to satisfactory occlusion in most cases. The risk from additional coil embolization does not negate the advantage of the initial embolization.