Different Factors Influence Recanalisation Rate After Coiling in Ruptured and Unruptured Intracranial Aneurysms

Iris Q.      Grunwald; Joyce S.      Balami; Daniela      Weber; Jessica      Mutter; Anna L.      Kuhn; Christoph      Krick; Wolfgang      Reith; Panagiotis      Papanagiotou; Kaveh      Shariat

Abstract

Background: Most studies evaluating long-term efficacy after coil embolisation of intracranial aneurysms have not differentiated between ruptured and unruptured aneurysms.

Objectives: The aim of this study was to analyse factors that influence recanalisation in ruptured and unruptured aneurysms.

Methods: We performed a retrospective analysis of 182 (98 ruptured, 84 unruptured) aneurysms, treated with coil embolisation alone that received follow-up with digital substraction angiography (DSA).

Results: At 6 months 26% of the aneurysms showed recanalisation. Multivariate variance analysis revealed that different factors influenced recanalisation in ruptured and unruptured aneurysms. In ruptured aneurysms patient age was a determinant, with younger patients recanalising more frequently than older ones (p = 0.016). Also, low initial packing density led to higher recanalisation rates (p = 0.015) than higher packing. In the unruptured aneurysm group these factors were not significant. Here, only a larger aneurysm volume led to higher recanalisation rates (p = 0.027).

Conclusions: Our data suggest that in ruptured aneurysms, high packing density is a key factor to prevent recanalisation, while in unruptured aneurysms, aneurysm volume is the main predictor for recanalisation.

Keywords: Intracranial, aneurysm, ruptured, unruptured, recanalisation.

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