Article Figures & Data
Figures
- Fig 1.
Examples for aneurysms categorized into group B (A,B) and group C (C,D).
A,C, Initial treatment result.
B,D, Situation at 6 months with control angiogram.
Tables
Characteristics Group A Aneurysms (n = 270) (%) Group B Aneurysms (n = 39) (%) Group C Aneurysms (n = 33) (%) Hunt and Hess grade No SAH 101 (37.4) 17 (43.6) 10 (30.3) I 56 (20.7) 11 (28.2) 8 (24.2) II 32 (11.9) 6 (15.4) 4 (12.1) III 45 (16.7) 3 (7.7) 5 (15.2) IV 17 (6.3) 0 (0.0) 1 (3.0) V 19 (7.0) 2 (5.1) 5 (15.2) Initial treatment result Complete occlusion (c/o) 197 (73.0) 25 (64.1) 16 (48.5) Neck remnant (n/r) 49 (18.1) 10 (25.6) 8 (24.2) Residual aneurysm (r/a) 24 (8.9) 4 (10.3) 9 (27.3) Aneurysm size Small (≤10 mm) and small neck (≤4 mm) 181 (67.0) 27 (69.2) 6 (18.2) Small (≤10 mm) and wide neck (>5 mm) 41 (15.2) 1 (2.6) 11 (33.3) Large (>10 mm) and small neck (≤4 mm) 10 (3.7) 0 (0.0) 4 (12.1) Large (>10 mm) and wide neck (>4 mm) 38 (14.1) 11 (28.2) 12 (36.4) Aneurysm location ICA 59 (21.9) 10 (25.6) 6 (18.2) ACA/AcomA 67 (24.8) 7 (17.9) 7 (21.2) MCA 23 (8.5) 1 (2.6) 3 (9.1) PCA/PcomA 34 (12.6) 5 (12.8) 3 (9.1) BA 65 (24.1) 15 (38.5) 14 (42.4) VA 22 (8.1) 1 (2.6) 0 (0.0) Note:—ICA indicates internal carotid artery; ACA, anterior cerebral artery; AcomA, anterior communicating artery; MCA, middle cerebral artery; PCA, posterior cerebral artery; PcomA, posterior communicating artery; BA, basilar artery; VA, vertebral artery; SAH, subarachnoid hemorrhage.
* Complete treatment (group A), recurrence without retreatment (group B), and recurrence with retreatment (group C).
Predictor Variables Univariate Analysis Multivariate Analysis OR (95% CI) P Value OR (95% CI) P Value Aneurysm location 1.06 (0.86–1.31) .56 n.a. n.a. Aneurysm size 3.97 (1.90–8.32) ≤.001 n.a. n.a. Aneurysm neck 2.47 (1.19–5.11) .015 n.a. n.a. Unfavorable anatomy† 3.45 (1.65–7.22) ≤.001 3.11 (1.43–6.75) .004 Initial treatment result 2.16 (1.35–3.47) ≤.001 1.86 (1.13–3.07) .014 Complete occlusion vs neck remnant 1.71 (0.70–4.17) .240 n.a. n.a. Complete occlusion vs residual aneurysm 5.05 (1.94–13.11) ≤.001 3.96 (1.48–10.65) .006 Hunt and Hess 1.13 (0.91–1.39) .283 n.a. n.a. SAH vs non-SAH 1.38 (0.64–3.01) .412 n.a. n.a. Note—n.a. indicates not applied; SAH, subarachnoid hemorrhage.
* Retreatment is defined as “response variable.” Variables identified as predictors for retreatment by univariate analysis (P<0.1) were entered into the multivariate analysis.
† Pearson χ2 test showed dependency of aneurysmal size and neck. Therefore, the multivariate analysis was performed for the combined variable “favorable anatomy” (aneurysmal size, ≤10 mm; neck width, ≤4 mm).
- Table 3:
Previous literature regarding recurrences and retreatment of aneurysms after initial coil embolization
Author Pts/Ayms with Angiographic F/U (%) Mean Angiographic F/U (months) Recurrences (%) Retreated Aneurysms (%) Rebleeding (p.a.) (%) Set of Retreated Recurrences (%) Combined M/M Recoiling (%) Byrne 199928 250/317 pts (78.9) 6–12 38/259 (14.7) 13/250 (5.2) 0.6–2.4 13/38 (34.2) Not reported Cognard 199936 169/203 ayms (83.3) 3.4 26/169 (15.5) 8/169 (4.7) 0.0 8/26 (30.8) Not reported Thornton 200237 141/196 ayms (71.9) 16.7 25/141 (17.7) Not reported 0.5 Not reported Not reported Murayama 20036 489/916 ayms (53.4) 11 102/489 (20.9) Not reported 0.5–1.6 Not reported Not reported Raymond 200314 381/501 ayms (76.5) Not specified* 128/381 (33.6) 39/381 (10.2) 0.3 39/128 (30.5) Not reported Slob 200429 400/488 ayms (82) 6 Not reported 48/400 (12) 1.1 Not reported 0 Henkes 200616 1680/2759 ayms (60.9) Not specified† Not reported 350/1680 (20.8) Not reported Not reported 3 Gallas 20052 571/705 ayms (81) 36 85/571 (14.9) 33/571 (5.8) 0.06 33/85 (38.8) Not reported CARAT 20069 299 pts with clinical F/U Not reported Not reported 35/299 (11.7) 0.11 Not reported 11 Kang 200615 250/522 ayms (47.9) 8 91/250 (36.4) 32/250 (12.8) 0.79 39/91 (42.8) 0 Own data 342/627 ayms (54.5) 28.6 72/342 (21.1) 33/342 (9.6) 0.6 33/72 (45.8) 0 Note:—Pts indicates patients; ayms, aneurysms; F/U, follow-up; p.a., per annum; MM, morbidity and mortality.
* Early F/U (3–12 months) in 353/501 aneurysms and late F/U (>12 months) in 277/501 aneurysms.
† Standard recommendation was to have F/U angiography at 6–12 months. Mean interval between first treatment and first F/U examination was 21 months (median, 14 months).
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