Digital subtraction angiography after intracranial aneurysm embolization: A follow-up study / 中国脑血管病杂志

ABSTRACT

Objective: To explore the problems of recanalization and rebleeding after intracranial aneurysm embolization and the necessity of digital subtraction angiography (DSA) follow-up. Methods: One hundred and two patients with intracranial aneurysm (114 aneurysms, of them, 2 patients with multiple intracranial aneurysms, each with one small aneurysm did not coiled) were selected for endovascular embolization with Guglielmi detachable coil (GDC), electrolytical detachable coil (EDC), mechanical detachable spiral (MDS) or Matrix detachable microcoils and were followed-up by the DSA from January 1997 to January 2005. The mean follow-up period was 10.5 months (1 month to 6.5 years) after the procedures. They were compared with the immediate DSA images after the embolizations. Results: Endovascular coiling procedures were performed in 112 aneurysms. 100% occlusion was 51.79% (58/112) after the initial embolization, ≥ 95% occlusion was 33.04% (37/112), and < 95% occlusion was 15.17% (17/112). After embolization, 87 (77.68% ) patients the coils were stable, 6 patients with residual aneurysms (5.36%), and 19 aneurysms (16.96%) recanalized. Among the 90 aneurysms embolized with GDC or EDC, 14 (15.56%) recanalized. Among the aneurysms with 100%, ≥95% and < 95% occlusion, their recanalize rates after the procedures were 4.08%, 26.67% and 36.36%, respectively, and there were significant differences among them (P < 0.01). Nine recanalized aneurysms were reembolized with GDC, and rebleeding did not occur. Among 5 recanalized aneurysms, 1 aneurysm experienced rebleeding later. Of the 18 aneurysms embolized with MDS recanalization, 5 recanalized during the follow-up period. The aneurysms treated with Matrix detachable microcoils or Neuroform stents + Matrix detachable microcoils, the aneurysms were occluded completely on follow-up DSA, even the inital occlusions were nearly complete or incomplete. Conclusion: The recanalization of intracranial aneurysms is associated with the initial embolization and the embolic materials used. DSA follow-up should be emphasized, and additional coiling should be performed if the aneurysm is recanalized.