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Do Contrast-Fill Patterns Immediately After Coil Embolization of Small Saccular Aneurysms Impact Long-Term Results?

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Abstract

Purpose

It is generally accepted that filling of a saccular aneurysm with contrast immediately after coil embolization predisposes to later recanalization. However, not all such scenarios evolve similarly over time. We investigated outcomes of small (≤ 7 mm) aneurysms with contrast-filled sacs immediately after coil embolization, evaluating the impact of pattern and degree of filling on subsequent recanalization.

Methods

Between January, 2008 and December, 2010, 186 small (≤ 7 mm) saccular aneurysms that retained contrast after coil embolization accrued for this study. Lesions were categorized by pattern (eccentric vs. concentric) and degree of filling on working projections. Clinical and morphologic factors were also analyzed to assess impact on subsequent recanalization. Morphologic outcomes at 6 months or more were assessed.

Results

In 93.5 % (174/186) of aneurysms with visible contrast retention, complete occlusion was evident on follow-up imaging studies at 6 months. Multiple logistic regression analysis indicated that eccentric (vs. concentric) contrast filling carried greater risk of subsequent recanalization (p = 0.020). Stent placement and progressive occlusion were also linked, falling short of statistical significance (p = 0.089). Of 166 progressively occluded aneurysms followed for more than 12 months (mean, 30.8 ± 7.3 months), 158 (95.2 %) exhibited stable occlusion.

Conclusion

Small (≤ 7 mm) aneurysms that retain contrast immediately after coil embolization are more likely to become completely occluded over time through progressive thrombosis. However, an eccentric fill pattern may predispose to recanalization.

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Acknowledgments

We thank Yoon-Kyung Choi for preparation of the illustrations.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurosurgery, Hallym University College of Medicine, Chuncheon, Korea

    J.P. Jeon MD

  2. Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu Seoul, Seoul 110-744, Seoul, Korea

    Y.D. Cho MD, J.K. Rhim MD, D.H. Yoo MD & M.H. Han MD, PhD

  3. Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea

    H.-S. Kang MD, PhD, J.E. Kim MD, PhD, W.S. Cho MD, PhD & M.H. Han MD, PhD

Authors
  1. J.P. Jeon MD
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  2. Y.D. Cho MD
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  3. J.K. Rhim MD
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  4. D.H. Yoo MD
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  5. H.-S. Kang MD, PhD
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  6. J.E. Kim MD, PhD
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  7. W.S. Cho MD, PhD
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  8. M.H. Han MD, PhD
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Corresponding author

Correspondence to Y.D. Cho MD.

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Jeon, J., Cho, Y., Rhim, J. et al. Do Contrast-Fill Patterns Immediately After Coil Embolization of Small Saccular Aneurysms Impact Long-Term Results?. Clin Neuroradiol 27, 205–211 (2017). https://doi.org/10.1007/s00062-015-0485-9

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  • DOI: https://doi.org/10.1007/s00062-015-0485-9

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