Document Detail


Late Reopening of Adequately Coiled Intracranial Aneurysms: Frequency and Risk Factors in 400 Patients With 440 Aneurysms.
MedLine Citation:
PMID:  21454823     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: In aneurysms that are adequately occluded 6 months after coiling, the risk of late reopening is largely unknown. We assessed the occurrence of late aneurysm reopening and possible risk factors. METHODS: From January 1995 to June 2005, 1808 intracranial aneurysms were coiled in 1675 patients at 7 medical centers. At 6 months, 1066 aneurysms in 971 patients were adequately occluded. At mean 6.0 years after coiling, of the 971 patients, 400 patients with 440 aneurysms underwent 3 Tesla magnetic resonance angiography to assess occlusion status of the aneurysms. Proportions and corresponding 95% CI of aneurysm reopening and retreatment were calculated. Risk factors for late reopening were assessed by univariate and multivariate logistic regression analysis, and included patient sex, rupture status of aneurysms, aneurysm size ≥10 mm, and aneurysm location. RESULTS: In 11 of 400 patients (2.8%; 95% CI, 1.4-4.9%) with 440 aneurysms (2.5%; 95% CI, 1.0-4.0%), late reopening had occurred; 3 reopened aneurysms were retreated (0.7%; 95% CI, 0.2-1.5%). Independent predictors for late reopening were aneurysm size ≥10 mm (OR 4.7; 95% CI, 1.3-16.3) and location on basilar tip (OR 3.9; 95% CI, 1.1-14.6). There were no late reopenings in the 143 anterior cerebral artery aneurysms. CONCLUSIONS: For the vast majority of adequately occluded intracranial aneurysms 6 months after coiling (those <10 mm and not located on basilar tip), prolonged imaging follow-up within the first 5 to 10 years after coiling does not seem beneficial in terms of detecting reopened aneurysms that need retreatment. Whether patients might benefit from screening beyond the 5- to 10-year interval is not yet clear.
Authors:
Sandra P Ferns; Marieke E S Sprengers; Willem Jan van Rooij; Wim H van Zwam; Gérard A P de Kort; Birgitta K Velthuis; Joanna D Schaafsma; René van den Berg; Menno Sluzewski; Patrick A Brouwer; Gabriël J E Rinkel; Charles B L M Majoie;
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-3-31
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  -     ISSN:  1524-4628     ISO Abbreviation:  -     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-4-1     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
From the Department of Radiology, Academic Medical Center, Amsterdam; Department of Radiology, St Elisabeth Ziekenhuis, Tilburg; Department of Radiology, Maastricht University Medical Center; Department of Radiology, University Medical Center, Utrecht; Department of Radiology, VU Medical Center Amsterdam; Department of Radiology, Leiden University Medical Center; Department of Neurology from the Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, the Netherlands.
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