TY - JOUR
T1 - Late Reopening of Adequately Coiled Intracranial Aneurysms Frequency and Risk Factors in 400 Patients With 440 Aneurysms
AU - Ferns, Sandra P.
AU - Sprengers, Marieke E. S.
AU - van Rooij, Willem Jan
AU - van Zwam, Wim H.
AU - de Kort, Gérard A. P.
AU - Velthuis, Birgitta K.
AU - Schaafsma, Joanna D.
AU - van den Berg, René
AU - Sluzewski, Menno
AU - Brouwer, Patrick A.
AU - Rinkel, Gabriël J. E.
AU - Majoie, Charles B. L. M.
PY - 2011
Y1 - 2011
N2 - Background and Purpose-In aneurysms that are adequately occluded 6 months after coiling, the risk of late reopening is largely unknown. We assessed the occurrence of late aneurysm reopening and possible risk factors. Methods-From January 1995 to June 2005, 1808 intracranial aneurysms were coiled in 1675 patients at 7 medical centers. At 6 months, 1066 aneurysms in 971 patients were adequately occluded. At mean 6.0 years after coiling, of the 971 patients, 400 patients with 440 aneurysms underwent 3 Tesla magnetic resonance angiography to assess occlusion status of the aneurysms. Proportions and corresponding 95% CI of aneurysm reopening and retreatment were calculated. Risk factors for late reopening were assessed by univariate and multivariate logistic regression analysis, and included patient sex, rupture status of aneurysms, aneurysm size >= 10 mm, and aneurysm location. Results-In 11 of 400 patients (2.8%; 95% CI, 1.4-4.9%) with 440 aneurysms (2.5%; 95% CI, 1.0-4.0%), late reopening had occurred; 3 reopened aneurysms were retreated (0.7%; 95% CI, 0.2-1.5%). Independent predictors for late reopening were aneurysm size >= 10 mm (OR 4.7; 95% CI, 1.3-16.3) and location on basilar tip (OR 3.9; 95% CI, 1.1-14.6). There were no late reopenings in the 143 anterior cerebral artery aneurysms. Conclusions-For the vast majority of adequately occluded intracranial aneurysms 6 months after coiling (those <10 mm and not located on basilar tip), prolonged imaging follow-up within the first 5 to 10 years after coiling does not seem beneficial in terms of detecting reopened aneurysms that need retreatment. Whether patients might benefit from screening beyond the 5- to 10-year interval is not yet clear. (Stroke. 2011;42:1331-1337.)
AB - Background and Purpose-In aneurysms that are adequately occluded 6 months after coiling, the risk of late reopening is largely unknown. We assessed the occurrence of late aneurysm reopening and possible risk factors. Methods-From January 1995 to June 2005, 1808 intracranial aneurysms were coiled in 1675 patients at 7 medical centers. At 6 months, 1066 aneurysms in 971 patients were adequately occluded. At mean 6.0 years after coiling, of the 971 patients, 400 patients with 440 aneurysms underwent 3 Tesla magnetic resonance angiography to assess occlusion status of the aneurysms. Proportions and corresponding 95% CI of aneurysm reopening and retreatment were calculated. Risk factors for late reopening were assessed by univariate and multivariate logistic regression analysis, and included patient sex, rupture status of aneurysms, aneurysm size >= 10 mm, and aneurysm location. Results-In 11 of 400 patients (2.8%; 95% CI, 1.4-4.9%) with 440 aneurysms (2.5%; 95% CI, 1.0-4.0%), late reopening had occurred; 3 reopened aneurysms were retreated (0.7%; 95% CI, 0.2-1.5%). Independent predictors for late reopening were aneurysm size >= 10 mm (OR 4.7; 95% CI, 1.3-16.3) and location on basilar tip (OR 3.9; 95% CI, 1.1-14.6). There were no late reopenings in the 143 anterior cerebral artery aneurysms. Conclusions-For the vast majority of adequately occluded intracranial aneurysms 6 months after coiling (those <10 mm and not located on basilar tip), prolonged imaging follow-up within the first 5 to 10 years after coiling does not seem beneficial in terms of detecting reopened aneurysms that need retreatment. Whether patients might benefit from screening beyond the 5- to 10-year interval is not yet clear. (Stroke. 2011;42:1331-1337.)
U2 - https://doi.org/10.1161/STROKEAHA.110.605790
DO - https://doi.org/10.1161/STROKEAHA.110.605790
M3 - Article
C2 - 21454823
SN - 0039-2499
VL - 42
SP - 1331
EP - 1337
JO - Stroke; a journal of cerebral circulation
JF - Stroke; a journal of cerebral circulation
IS - 5
ER -