RT Journal Article
SR Electronic
T1 Long-Term Prospective Follow-Up of Intracranial Aneurysms Treated with Endovascular Coiling Using Contrast-Enhanced MR Angiography
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1211
OP 1215
DO 10.3174/ajnr.A2064
VO 31
IS 7
A1 J.J.S. Shankar
A1 C. Lum
A1 N. Parikh
A1 M. dos Santos
YR 2010
UL http://www.ajnr.org/content/31/7/1211.abstract
AB BACKGROUND AND PURPOSE: Catheter angiography has been the criterion standard for follow-up evaluation of coiled intracranial aneurysms. In our center, CE-MRA has been used to evaluate aneurysm recanalization. Our aim was to investigate the feasibility and usefulness of a CE-MRA protocol for following patients with intracranial aneurysms treated with endovascular coiling. MATERIALS AND METHODS: From September 2003 to December 2006, 134 aneurysms were treated by endovascular coiling in 124 patients by using detachable coils. These patients were followed with CE-MRA at 3 months, 15 months, and 3 and 5 years. MRAs were analyzed by 2 interventional neuroradiologists. Findings were assigned to 3 categories: complete obliteration (class 1), residual neck (class 2), and residual aneurysm (class 3). RESULTS: Initially, CE-MRA demonstrated 67 (50%) complete obliterations (class 1), 57 (41.79%) residual necks (class 2), and 8 (5.97%) residual aneurysms (class 3). No patient experienced rebleed during the follow-up period. A total of 214 patient-years of follow-up were obtained (range, 0–53 months). Two (1.49%) patients died after the follow-up, and 11 (8.21%) patients were lost to follow-up. On follow-up, 76 (56.72%) patients showed stable results. Fifty-six (41.79%) aneurysms showed change in their obliteration pattern. Of these 56, 47 demonstrated recanalization and 9 (6.72%) showed further obliteration. Most of the aneurysms that showed change in their obliteration remained stable on follow-up. Only 11 (8.21% of the total and 23.4% of those who showed recanalization) patients underwent recoiling or clipping. CONCLUSIONS: CE-MRA can be used in routine practice to follow-up aneurysm recanalization noninvasively. CE-MRA permits close-interval follow-up and may show more filling of the aneurysm neck or sac than DSA. ACAanterior cerebral arteryAcomAanterior communicating arteryAICAanterior inferior cerebellar arteryCE-MRAcontrast-enhanced MRACTACT angiographyDSAdigital subtraction angiographyFLASHfast low-angle shotICAinternal carotid arteryISATInternational Subarachnoid Aneurysm TrialMCAmiddle cerebral arteryMIPmaximum intensity projectionMRAMR angiographyPCAposterior cerebral arteryPcomAposterior communicating arteryPICAposterior inferior cerebellar arterySAHsubarachnoid hemorrhageTOFtime of flight