Related Experiment Video
Updated: Aug 16, 2026
07:21
Microsurgical Creation of Giant Bifurcation Aneurysms in Rabbits for the Evaluation of Endovascular Devices
Published on: September 8, 2023
The relation between packing and reopening in coiled intracranial aneurysms: a prospective study
Marjan J Slob1, Menno Sluzewski, Willem Jan van Rooij
1Department of Radiology, St. Elisabeth Ziekenhuis, GC Tilburg, The Netherlands.
Neuroradiology
|September 2, 2005
Summary
Packing intracranial aneurysms with coils above 24% volume effectively prevents reopening due to compaction. However, undetected thrombosis may still cause reopening, necessitating follow-up angiography.
Area of Science:
- Neurosurgery
- Interventional Radiology
- Vascular Neurology
Background:
- Coiling is a common treatment for intracranial aneurysms.
- Aneurysm reopening after coiling is a known complication.
- Packing density is a key factor influencing treatment outcome.
Purpose of the Study:
- To prospectively evaluate the relationship between coil packing density and aneurysm reopening after treatment.
- To determine if a packing density threshold of 24% protects against aneurysm reopening.
Main Methods:
- Prospective evaluation of 82 patients with intracranial aneurysms treated with detachable coils.
- Calculation of packing density (coil volume/aneurysm volume x 100%) using 3D angiography.
- Assessment of aneurysm reopening at 6-month follow-up angiography.
Main Results:
- Twenty-three of 82 aneurysms (28%) showed reopening at 6 months.
- Reopening was primarily caused by coil compaction (20 aneurysms).
- Only 3 of 29 aneurysms (10%) with packing >24% reopened, and these had undetected intraluminal thrombosis.
Conclusions:
- Coil packing density >24% significantly protects against reopening caused by compaction in non-thrombosed aneurysms.
- Undetected intraluminal thrombosis can lead to reopening even with high packing density.
- Continued follow-up angiography is recommended for all coiled aneurysms, regardless of packing density.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
01:30Aneurysm I: Introduction
An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
01:29Increased Intracranial Pressure ll: Pathophysiology
Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...