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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
Early major recurrence of cerebral aneurysms after satisfactory initial coiling
Mohamad Abdalkader1, Jean Raymond2, Asim Mian1
1Department of Radiology, Boston Medical Center, Boston, MA, USA.
Early major recurrence of cerebral aneurysms after coiling is rare (1.2%) but carries a risk of re-rupture. Close monitoring with early angiography is recommended for small ruptured aneurysms post-treatment.
Area of Science:
- Neurosurgery
- Interventional Neuroradiology
- Vascular Neurology
Background:
- Cerebral aneurysms treated with endovascular coiling can recur.
- Early major recurrence (EMR) post-coiling is not well-characterized.
- Understanding EMR is crucial for patient management and preventing re-rupture.
Purpose of the Study:
- To determine the frequency of EMR after cerebral aneurysm coiling.
- To identify risk factors associated with EMR.
- To inform clinical practice regarding post-coiling surveillance.
Main Methods:
- Retrospective review of 338 cerebral aneurysms treated with coiling (July 2009-June 2019).
- Definition of EMR: aneurysm size > initial size within 6 months post-coiling.
- Analysis of patient demographics, aneurysm characteristics, and technical details.
Main Results:
- EMR occurred in 4 out of 338 aneurysms (1.2%) within 6 months.
- EMR was detected between 4-20 weeks post-coiling.
- All EMR cases involved ruptured aneurysms with low aspect ratios and communicating segment involvement.
Conclusions:
- EMR is a rare but significant complication of cerebral aneurysm coiling.
- EMR poses an impending risk of aneurysm re-rupture.
- Early follow-up angiography may be beneficial for small ruptured aneurysms post-coiling.
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