Document Detail


Cerebral aneurysm sac growth as the etiology of recurrence after successful coil embolization.
MedLine Citation:
PMID:  22180247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Coil compaction is thought to be the main mechanism for recurrence in cerebral aneurysms with previously successful coil embolization. We hypothesize that sac growth may be equally or more important. The objective was to study the relative roles of coil compaction and sac growth as explanations for aneurysm recurrence requiring retreatment in a study population using quantitative 3D image processing methods.
METHODS: From July 2009 to December 2010, 175 aneurysms were coiled at the University of Iowa hospitals and clinics. Eight aneurysms had major recurrence requiring retreatment (4.4-12.1 months between procedures; mean: 7.2 months). The 3D structures of the vessel and coil mass were reconstructed using rotational angiography data scanned before and after both initial coil embolization and retreatment. Changes in the sac and coil mass over time were visualized using model registration techniques and quantified using volume calculations.
RESULTS: All 8 of the coiled aneurysms with major recurrence had significant aneurysm sac growth (15% to 102% increase in volume), independent of change in coil volume. Five aneurysms with major recurrence had sufficient data for assessment of coil compaction. The coil mass volume decreased in 1 aneurysm (12% compaction by volume), did not change significantly in 1 aneurysm (increased by 1%), and significantly increased in 3 aneurysms (8%, 21%, and 25%) between the first treatment and before the second treatment.
CONCLUSIONS: In this study population, aneurysm sac growth, not coil compaction, was the primary mechanism associated with recurrence after initial coil embolization.
Authors:
David M Hasan; Alexander I Nadareyshvili; Anna L Hoppe; Kelly B Mahaney; David K Kung; Madhavan L Raghavan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2011-12-15
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  43     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-21     Completed Date:  2012-08-15     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  866-8     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anatomy, Cross-Sectional
Aneurysm, Ruptured / pathology,  surgery
Angiography, Digital Subtraction
Blood Vessel Prosthesis
Cerebral Angiography
Embolization, Therapeutic / methods*
Female
Humans
Image Processing, Computer-Assisted
Imaging, Three-Dimensional
Intracranial Aneurysm / etiology,  pathology*,  surgery*
Male
Middle Aged
Recurrence
Young Adult
Grant Support
ID/Acronym/Agency:
HL083475/HL/NHLBI NIH HHS; R01 HL083475/HL/NHLBI NIH HHS; R03 NS079227/NS/NINDS NIH HHS
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