Long-Term Hemorrhage and Reperfusion Rates of Coiled Aneurysms: A Single-Center Experience

Area of Science:

• Neurosurgery
• Vascular Surgery
• Interventional Radiology

Background:

• Endovascular therapy is standard for intracranial aneurysms (IAs) but long-term durability varies.
• Hemorrhage prevention is a key goal, necessitating evaluation of treatment durability.
• Assessing long-term outcomes of endovascular IA treatment is crucial for clinical decision-making.

Purpose of the Study:

• To evaluate the safety and effectiveness of an endovascular approach for intracranial aneurysms (IAs).
• To determine long-term intracranial aneurysm (IA) hemorrhage rates and reperfusion following endovascular treatment.
• To identify independent risk factors for long-term intracranial aneurysm (IA) reperfusion.

Main Methods:

• Retrospective, single-center study of patients with endovascularly treated intracranial aneurysms (IAs) from 2008-2020.
• Minimum 12-month follow-up, assessing primary endpoints of hemorrhage rates and reperfusion.
• Secondary endpoints included treatment-related morbidity and mortality; multivariate logistic regression analyzed reperfusion predictors.

Main Results:

• Endovascular treatment was used for 333 intracranial aneurysms (IAs); 57% ruptured at presentation.
• Long-term follow-up (median 34 months) showed 47% reperfusion, requiring retreatment in 32%.
• Only 1% experienced long-term hemorrhage; multilobarity and age ≥50 predicted reperfusion.

Conclusions:

• A deliberate endovascular approach for intracranial aneurysms (IAs) demonstrates a low long-term hemorrhage rate.
• Endovascular treatment is a safe and effective option, with low intervention-related morbidity (4.8%) and no mortality.
• The findings support the justification of a deliberate endovascular treatment strategy for intracranial aneurysms (IAs).