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Progressive thrombosis of unruptured aneurysms after coil embolization: analysis of 255 consecutive aneurysms.
- Source :
-
Journal of neurointerventional surgery [J Neurointerv Surg] 2019 Nov; Vol. 11 (11), pp. 1113-1117. Date of Electronic Publication: 2019 Apr 11. - Publication Year :
- 2019
-
Abstract
- Introduction: We have observed that aneurysms treated by insufficient coil embolization and filled with contrast agent immediately after the procedure are often completely occluded at follow-up. However, there are limited studies showing progressive thrombosis of aneurysms after coil embolization. Herein, we describe our experience with coil embolization for aneurysms, and discuss the factors involved in progressive thrombosis.<br />Methods: A total of 255 aneurysms treated by coil embolization in our institute between January 2011 and June 2017 and observed >6 months were included. 'Progressive thrombosis' indicated that aneurysms that were neck remnant (NR) or dome filling (DF) immediately after coil embolization changed to complete obliteration (CO) at the 6-month follow-up digital subtraction angiography. The factors involved in progressive thrombosis were assessed.<br />Results: In all aneurysms (n=255), 24 (9.4%) were CO, 82 (32.2%) were NR, and 149 (58.4%) were DF immediately after the procedure. At 6-month digital subtraction angiography, 123 (48.2%) were CO, 95 (37.3%) were NR, and 37 (14.5%) were DF. Retreatment for major recanalization was performed in eight cases (3.1%). One hundred and three aneurysms showed progressive thrombosis. There were significant differences in aneurysm location (P=0.0002), aneurysm dome diameter (P=0.0015), aneurysm neck diameter (P=0.0068), volume embolization ratio (P=0.0054), and endovascular procedure with stent (P=0.0264) between the progressive thrombosis and no thrombosis groups.<br />Conclusions: Progressive thrombosis can occur in aneurysms after coil embolization depending on aneurysm location and size, and stent use. Thus, the degree of coil embolization and combination with a stent should be adjusted depending on aneurysm type.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Adult
Aged
Angiography, Digital Subtraction methods
Angiography, Digital Subtraction trends
Blood Vessel Prosthesis adverse effects
Embolization, Therapeutic adverse effects
Endovascular Procedures adverse effects
Endovascular Procedures methods
Endovascular Procedures trends
Female
Follow-Up Studies
Humans
Intracranial Aneurysm therapy
Male
Middle Aged
Retrospective Studies
Stents trends
Thrombosis therapy
Treatment Outcome
Blood Vessel Prosthesis trends
Disease Progression
Embolization, Therapeutic methods
Embolization, Therapeutic trends
Intracranial Aneurysm diagnostic imaging
Thrombosis diagnostic imaging
Subjects
Details
- Language :
- English
- ISSN :
- 1759-8486
- Volume :
- 11
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- Journal of neurointerventional surgery
- Publication Type :
- Academic Journal
- Accession number :
- 30975739
- Full Text :
- https://doi.org/10.1136/neurintsurg-2019-014775