Does Systemic Hypertension Impact Recanalization of Coiled Aneurysms?

Area of Science:

• Neurosurgery
• Cardiovascular Medicine
• Radiology

Background:

• Hypertension is a known risk factor for aneurysm formation, growth, and rupture.
• Hemodynamic stress influences the recanalization of coiled aneurysms.
• The specific impact of hypertension on coiled aneurysm recanalization remains under-investigated.

Purpose of the Study:

• To investigate the relationship between hypertension and the outcomes of coiled intracranial aneurysms.
• To analyze the effect of controlled versus uncontrolled hypertension on aneurysm recanalization.
• To compare recanalization rates between hypertensive and non-hypertensive patients using matched analysis.

Main Methods:

• A cohort of 715 patients undergoing coil embolization for intracranial aneurysms (2011-2013) was studied.
• Angiography (MR or conventional) assessed aneurysm occlusion using the Raymond classification.
• Patients were categorized by hypertension status (controlled/uncontrolled) and matched 1:1 with non-hypertensive controls.

Main Results:

• 67.7% of patients were hypertensive; 18.0% experienced aneurysm recanalization over ~28.6 months.
• Initial analysis showed similar cumulative recanalization rates between hypertensive and non-hypertensive groups (p=0.297).
• After 1:1 matching, recanalization rates remained similar (13.5% vs. 14.3%, p=0.578), with no difference between controlled and uncontrolled hypertension subgroups.

Conclusions:

• Systemic hypertension does not appear to influence the recanalization of coiled intracranial aneurysms.
• This finding contrasts with hypertension's known effects on aneurysm formation, growth, and rupture.
• Recanalization outcomes seem independent of hypertension status post-embolization.