Progressive Occlusion and Recanalization after Endovascular Treatment for 287 Unruptured Small Aneurysms (

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Progressive Occlusion and Recanalization after Endovascular Treatment for 287 Unruptured Small Aneurysms (<5mm): A Single-Center 6-Year Experience.

World Neurosurg. 2017 Apr 14;:

Authors: Feng X, Wang L, Guo E, Zhang B, Qian Z, Liu P, Wen X, Xu W, Li Y, Jiang C, Wu Z, Liu A

Abstract
OBJECT: We aimed to investigate the effect of coiling for small unruptured intracranial aneurysms(UIAs)﹤5mm) on progressive occlusion and recanalization, and the dubious factors related to progressive occlusion and recanalization among UIAs without complete occlusion.
METHODS: A total of 264 patients with 287 small UIAs were coiled in our institute between June 2009 and December 2014. All UIAs enrolled were divided into small (3-5mm) and very small (＜3mm) groups, and UIAs without initial complete occlusion were divided into progressive, stable and recanalization groups. Baseline characteristics, procedure-related complications, angiographic follow-up results, and clinical outcomes were statistically analyzed.
RESULTS: Among 287 aneurysms, 211 aneurysms (73.5%) were completely coiled, three (1.2%) intraoperative ruptures and 12 (4.2%) perioperative thromboembolic events occurred. Angiographic follow-up was available for 174 patients(65.9%), the incidence of recanalization was 5.7%. Among 56 aneurysms without complete occlusion, 43 (76.8%) had progressive occlusion and 6(10.7%) had recanalization. Anatomic results of initial and follow-up between small and very small groups were similar in both groups. On logistic regression analysis, smaller size (＜3mm) without complete occlusion related to recanalization(OR, 8.0, 95% CI, 1.3-50.0, P=0.026).
CONCLUSIONS: Our study suggested that coil embolization of small UIAs can achieve a high rate of progressive occlusion and low rate of recanalization during follow-up. Anatomic results of initial and follow-up between small (3-5mm) and very small (＜3mm) groups were similar in both groups. What's more, smaller size (＜3mm) without complete occlusion may relate to recanalization.

PMID: 28416410 [PubMed - as supplied by publisher]

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