Article
Coil treatment of 2029 intracranial aneurysms: Follow-up data in 1063 aneurysms
Coil-Okklusion von 2029 intrakraniellen Aneurysmen: Verlaufsergebnisse von 1063 Aneurysmen
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Published: | April 23, 2004 |
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Outline
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Objective
To evaluate the mid- and long-term results of the endovascular coil occlusion of intracranial aneurysms.
Methods
Retrospective data registry of the angiographic and clinical results of the subsequent endovascular treatment sessions and follow-up examinations of 1063 out of 2029 (52.4%) intracranial aneurysms which underwent follow-up examinations, carried out in a single center between November 1992 and November 2003.
Results
In 1063 aneurysms the first angiographic follow-up examination was performed at a mean interval of 23.5 months after the first treatment session and showed a 90-100% aneurysm occlusion in 771 aneurysms (72.5%). A degree of occlusion below 90% was found in 292 aneurysms (27.5%), and 203 (69.5%) of these aneurysms had previously been occluded at 90-100%. Detailed anatomic analysis revealed any type of recurrence in 337 aneurysms (31.7%), which was mostly attributed to either coil compaction (n=271, 25.5%) or coil migration into thrombus (n=28, 2.6%). Repeated treatment sessions after the first coil treatment were carried out as follows: 1 in 154 aneurysms, 2 in 33 aneurysms, 3 in 11 aneurysms, 4 in 4 aneurysms, 5 in 1 aneurysm, 7 in 1 aneurysm, 8 in 1 aneurysm. In 26 aneurysms (1.2%) rupture after endovascular coil occlusion was documented. For 922 patients clinical follow-up data comprising 35676 patients-months (equivalent to 2973 patient-years) are available. In 816 of these 922 patients (88.5%) the clinical condition at a mean of 37 months after the 1st treatment session was (according to the Glasgow Outcome Scale) graded as GOS V.
Conclusions
The clinical long-term results after the endovascular coil-occlusion of intracranial aneurysms are obviously good. Various degrees of neck recurrence are frequently observed and are mostly due to coil compaction. The low rate of aneurysm (re-)bleeding after coil treatment is encouraging but confirms the need for angiographic follow-up examinations and eventually re-treatments.