Background
Stent-assisted coil embolization (SACE) is used to address wide-necked or complex
aneurysms. However, as they may recanalize after SACE, predictors of recanalization
are needed. We investigated the relationship between follow-up angiographic results
and the morphology of sidewall (SW) aneurysms in patients treated by SACE.
Methods
Between September 2010 and September 2014, we performed 80 SACE procedures for SW
intracranial aneurysms. Angiographic findings, obtained immediately after the procedure,
3-6 months thereafter, and when aneurysmal recanalization was suspected on MR angiogram
scan, were recorded. Morphologically, the SW aneurysms were classified as “outside”
(OS) and “partially inside” (PI) based on the curve of the axes of the proximal or
distal parent artery with respect to the aneurysmal neck. Follow-up angiographic studies
on OS- and PI SW aneurysms were compared.
Results
On the initial angiograms, we classified 42 aneurysms as OS and 38 as PI. Immediately
after SACE, there was no significant difference in the angiographic findings on OS
and PI aneurysms. However, on follow-up angiograms, there was a significant difference
in the rate of spontaneous improvement (4 of 42 [OS] versus 21 of 38 [PI], P = .001). We performed additional coil embolization to treat 3 recanalized OS aneurysms.
Conclusions
SW aneurysms classified morphologically as PI tended to occlude progressively even
after incomplete occlusion by SACE. In contrast, aneurysms classified as OS must be
observed carefully after SACE.
Key Words
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Article info
Publication history
Published online: December 04, 2015
Accepted:
November 1,
2015
Received in revised form:
September 29,
2015
Received:
June 19,
2015
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.001
Copyright
© 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.
