Article
Stability of coil occlusion: angiographic follow-up results in 1673 out of 2740 intracranial aneurysms
Wie dauerhaft ist die Coil-Behandlung intrakranieller Aneurysmen? Angiographische Verlaufsuntersuchungen bei 1673 von 2740 Aneurysmen
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Published: | May 8, 2006 |
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Objective: To evaluate the mid- and long-term stability of intracranial aneurysm occlusion after endovascular coil treatment.
Methods: Between 11/1992 and 10/2005 coil treatment was performed in 2740 intracranial aneurysms and angiographic follow-up was obtained in 1673 (61%). Retrospective analysis of aneurysm occlusion was done for first and subsequent treatment sessions.
Results: The initial occlusion rate (OR) at the time of first treatment was ≥90% (subtotal or total occlusion) in 89% of the aneurysms. Angiographic follow-up at 14 months (median) showed total/subtotal occlusion in 74% of the aneurysms. Re-coiling (n=482) resulted in total/subtotal occlusion in 80% but was found to be only 46% at 14 months. From initial treatment to follow-up, OR was unchanged in 62%, improved in 11% and impaired in 27%. In 22% of these, coil compaction was the mechanism. Among the various materials used, the combination of nylon-fibered coils and Neuroform stents provided the best protection against aneurysm recanalisation.
Conclusions: Aneurysm recanalisation remains a concern, which requires angiographic follow-up and possibly necessitates retreatment.