Angiographic outcome of intracranial aneurysms with neck remnant following coil embolization

Justin R Mascitelli, Eric K. Oermann, Reade A. De Leacy, Henry Moyle, Aman B. Patel

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: The degree of aneurysm occlusion following coil embolization has an impact on aneurysm recanalization. Objective: To explain the natural history of intracranial aneurysms with neck remnant, Raymond-Roy Occlusion Classification (RROC) class II. Methods: A single-center, retrospective study of 198 patients with 209 aneurysms treated with coil embolization that were initially either RROC class I or II. The angiographic outcomes at short- and long-term follow-up were compared as well as the complication/re-treatment rates. Atypical aneurysms and those that had been previously treated were excluded. Results: Ninety-nine class I aneurysms were compared with 110 class II aneurysms. There was no difference in recanalization rate between the groups (class I 3.3% vs class II 8.5%, p=0.478) at short-term follow-up (8.2 months) and at subsequent follow-ups (21.7 and 52.1 months). There was also no difference in re-treatment rates (class I 3.3% vs class II 8.5%, p=0.196) or complication rates (class I 9.1% vs class II 4.6%, p=0.12). There were no aneurysm ruptures after treatment in either group. Conclusions: The angiographic outcome of aneurysms with neck remnant following coil embolization is similar to that of completely occluded aneurysms in that most remain stable and few recanalize. This understanding could potentially help the interventional neurosurgeon avoid complications such as coil herniation, vessel compromise, and stroke in selected cases. Further investigation with a larger patient population is warranted.

Original languageEnglish (US)
Pages (from-to)484-489
Number of pages6
JournalJournal of NeuroInterventional Surgery
Volume7
Issue number7
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Intracranial Aneurysm
Aneurysm
Neck
Rupture
Therapeutics
Retrospective Studies
Stroke

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Angiographic outcome of intracranial aneurysms with neck remnant following coil embolization. / Mascitelli, Justin R; Oermann, Eric K.; De Leacy, Reade A.; Moyle, Henry; Patel, Aman B.

In: Journal of NeuroInterventional Surgery, Vol. 7, No. 7, 01.01.2015, p. 484-489.

Research output: Contribution to journalArticle

Mascitelli, Justin R ; Oermann, Eric K. ; De Leacy, Reade A. ; Moyle, Henry ; Patel, Aman B. / Angiographic outcome of intracranial aneurysms with neck remnant following coil embolization. In: Journal of NeuroInterventional Surgery. 2015 ; Vol. 7, No. 7. pp. 484-489.
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abstract = "Background: The degree of aneurysm occlusion following coil embolization has an impact on aneurysm recanalization. Objective: To explain the natural history of intracranial aneurysms with neck remnant, Raymond-Roy Occlusion Classification (RROC) class II. Methods: A single-center, retrospective study of 198 patients with 209 aneurysms treated with coil embolization that were initially either RROC class I or II. The angiographic outcomes at short- and long-term follow-up were compared as well as the complication/re-treatment rates. Atypical aneurysms and those that had been previously treated were excluded. Results: Ninety-nine class I aneurysms were compared with 110 class II aneurysms. There was no difference in recanalization rate between the groups (class I 3.3{\%} vs class II 8.5{\%}, p=0.478) at short-term follow-up (8.2 months) and at subsequent follow-ups (21.7 and 52.1 months). There was also no difference in re-treatment rates (class I 3.3{\%} vs class II 8.5{\%}, p=0.196) or complication rates (class I 9.1{\%} vs class II 4.6{\%}, p=0.12). There were no aneurysm ruptures after treatment in either group. Conclusions: The angiographic outcome of aneurysms with neck remnant following coil embolization is similar to that of completely occluded aneurysms in that most remain stable and few recanalize. This understanding could potentially help the interventional neurosurgeon avoid complications such as coil herniation, vessel compromise, and stroke in selected cases. Further investigation with a larger patient population is warranted.",
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