doi: 10.3174/ajnr.A1181
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
American Journal of Neuroradiology 29:1768-1774, October 2008
© 2008 American Society of Neuroradiology
INTERVENTIONAL
Stability of Intracranial Aneurysms Adequately Occluded 6 Months after Coiling: A 3T MR Angiography Multicenter Long-Term Follow-Up Study
a Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg, the Netherlands
b Department of Radiology, Academisch Medisch Centrum, Amsterdam, the Netherlands
c Department of Radiology, Universitair Medisch Centrum, Utrecht, the Netherlands
Please address correspondence to Willem Jan van Rooij, MD, PhD, Department of Radiology, St. Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, 5022 GC Tilburg, the Netherlands; e-mail: radiol{at}knmg.nl
BACKGROUND AND PURPOSE: The long-term fate of coiled intracranial aneurysms is largely unknown, and prolonged imaging follow-up has been advocated. The yield of follow-up imaging in coiled aneurysms adequately occluded at 6 months is unknown. In such patients, we performed time-of-flight MR angiography (MRA) to assess the incidence and therapeutic consequences of reopening 5–11 years after coiling.
MATERIALS AND METHODS: Between 1995 and 2002, 661 aneurysms in 607 patients were coiled in 3 participating centers. Six-month follow-up angiograms were obtained in 497 (75%) aneurysms, of which 316 (64%) in 297 patients were adequately occluded. Of 297 patients, 84 were excluded for various reasons and 73 could not be traced. Of 140 eligible patients, 104 (74%) with 111 aneurysms were studied with 3T MR imaging and high-resolution MRA at a mean of 6.0 years after coiling (median, 5.6 years; range, 5.0–10.6 years).
RESULTS: The proportion of aneurysms with reopening was 3.6% (4/111; 95% confidence interval [CI], 1.1%–9.2%). One reopened aneurysm, which initially contained intraluminal thrombus, was additionally coiled (0.9%; 95% CI, 0.0%–5.4%).
CONCLUSION: In intracranial aneurysms with adequate occlusion at 6 months after coiling, the proportion of reopening needing retreatment after >5 years is low. The number of reopened aneurysms with therapeutic consequences was too small to assess risk factors, but probably the presence of intraluminal thrombus is one such risk factor. Most patients with coiled intracranial aneurysms that are adequately occluded at 6 months might not need prolonged imaging follow-up.