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Updated: May 14, 2026

Minimally Invasive Thumb-sized Pterional Craniotomy for Surgical Clip Ligation of Unruptured Anterior Circulation Aneurysms
Published on: August 11, 2015
Different factors influence recanalisation rate after coiling in ruptured and unruptured intracranial aneurysms
Iris Q Grunwald1, Joyce S Balami, Daniela Weber
1Acute Vascular Imaging Centre, NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford OX3 9DU, UK. i.grunwald@gmx.net
Background:
Most studies evaluating long-term efficacy after coil embolisation of intracranial aneurysms have not differentiated between ruptured and unruptured aneurysms.
Objectives:
The aim of this study was to analyse factors that influence recanalisation in ruptured and unruptured aneurysms.
Methods:
We performed a retrospective analysis of 182 (98 ruptured, 84 unruptured) aneurysms, treated with coil embolisation alone that received follow-up with digital substraction angiography (DSA).
Results:
At 6 months 26% of the aneurysms showed recanalisation. Multivariate variance analysis revealed that different factors influenced recanalisation in ruptured and unruptured aneurysms. In ruptured aneurysms patient age was a determinant, with younger patients recanalising more frequently than older ones (p = 0.016). Also, low initial packing density led to higher recanalisation rates (p = 0.015) than higher packing. In the unruptured aneurysm group these factors were not significant. Here, only a larger aneurysm volume led to higher recanalisation rates (p = 0.027).
Conclusions:
Our data suggest that in ruptured aneurysms, high packing density is a key factor to prevent recanalisation, while in unruptured aneurysms, aneurysm volume is the main predictor for recanalisation.
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