Angiographic Recurrence after Endovascular Coil Embolization for Intracranial Aneurysm

Keum, Han Joong; Hu, Chul; Whang, Kum; Jung, Hyun Ho; Pyen, Jhin Soo; Hong, Soon Ki; Lee, Myung Sub

Abstract

OBJECTIVE
We have investigated the risk factors associated with angiographic recurrence of intracranial aneurysms after endovascular coil embolization in a retrospective manner.
METHODS
From January 2000 to June 2005, 128 aneurysms in 114 patients were treated with coil embolization. Among them, 54 aneurysms in 51 patients were followed by repeated intraarterial angiography at 6, 12, 18, and 24 months post-embolization. Recurrence was defined when either coil compaction or aneurysm regrowth was identified on follow-up angiography. Patients were divided into stable and recurred groups according to angiographic recurrence. Clinical parameters, anatomical factors, and the degree of occlusion were retrospectively reviewed.
RESULTS
The overall recurrence rate was 29% in our study. The diameter of the largest dimension of the fundus was larger in the recurred group of patients as compared to the stable group of patients (7.33+/-2.26 mm vs. 5.87+/-1.93mm, p = 0.048), and a significant rate of recurrence was seen in fundus size of the same or greater than 10 mm (41.7% vs 14.3%, p = 0.038). The coil packing density was significantly smaller in the recurred group of patients (p = 0.002), with a recurrence rate of 47.0% in cases with a coil packing density below 25% (p = 0.017).
CONCLUSIONS
Our study showed that maximum aneurysm fundus size and coil packing density had a close correlation to recurrence. However, a larger number of patients with longer observation times may be needed to define the risk factors affecting angiographic recurrence.