Skip to main content

Advertisement

SpringerLink
Log in

Factors predicting retreatment and residual aneurysms at 1 year after endovascular coiling for ruptured cerebral aneurysms: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan

  • Interventional Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Abstract

Introduction

Endovascular treatment of cerebral aneurysms includes follow-up imaging to identify aneurysms that may need retreatment. The aim of this study was to determine predictors of incomplete aneurysm occlusion at 1 year after endovascular coiling for ruptured cerebral aneurysms.

Methods

In 129 patients of the Prospective Registry of Subarachnoid Aneurysms Treatment cohort, ruptured aneurysms were coiled within 14 days of onset and both initial post-coiling and 1-year follow-up digital subtraction angiography or magnetic resonance angiography were obtained. Factors predicting 1-year incomplete aneurysm occlusion (retreatment within 1-year or residual aneurysms at 1 year) were determined using multivariate logistic regression analyses.

Results

One-year incomplete aneurysm occlusion was identified in 59 patients, including ten patients who were retreated within 1-year post-coiling. Dome size ≥7.5 mm (P = 0.007, odds ratio (OR) = 5.00, 95% confidence interval (CI) = 1.55–16.15), pre-treatment aneurysm re-rupture (P = 0.023, OR = 3.50, 95% CI = 1.19–10.31), non-small size/small neck aneurysm (dome size, ≥10 mm or neck size, ≥4 mm; P = 0.022, OR = 3.26, 95% CI = 1.19–8.96), and residual aneurysms on immediate post-coiling angiograms (P = 0.017, OR = 1.43, 95% CI = 1.07–1.93) significantly predicted incomplete aneurysm occlusion at 1-year post-coiling.

Conclusions

In addition to the characteristics of aneurysm and initially incomplete aneurysm occlusion, this study showed pre-treatment aneurysm re-rupture to be a predictor that favors closer imaging follow-ups for coiled aneurysms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

A:

Aneurysmal diameter

CT:

Computed tomography

DSA:

Digital subtraction angiography

MRA:

Magnetic resonance angiography

mRS:

Modified Rankin Scale

N:

Neck size

PRESAT:

Prospective Registry of Subarachnoid Aneurysms Treatment

SAH:

Subarachnoid hemorrhage

References

  1. International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group (2002) International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet 360:1267–1274

    Article  Google Scholar 

  2. Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P, for the International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group (2005) International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised comparison of effects on survival, dependency, seizures, rebleeding, subgroups, and aneurysm occlusion. Lancet 366:809–817

    Article  PubMed  Google Scholar 

  3. Byrne JV, Sohn MJ, Molyneux AJ (1999) Five year experience in using coil embolisation of ruptured intracranial aneurysms: outcomes and incidence of late re-bleeding. J Neurosurg 90:656–663

    Article  PubMed  CAS  Google Scholar 

  4. van Rooij WJ, Sluzewski M (2009) Opinion: imaging follow-up after coiling of intracranial aneurysms. AJNR Am J Neuroradiol 30:1646–1648

    Article  PubMed  Google Scholar 

  5. Raymond J, Guilbert F, Weill A, Georganos SA, Juravsky L, Lambert A, Lamoureux J, Chagnon M, Roy D (2003) Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke 34:1398–1403

    Article  PubMed  Google Scholar 

  6. Ries T, Siemonsen S, Thomalla G, Grzyska U, Zeumer H, Fiehler J (2007) Long-term follow-up of cerebral aneurysms after endovascular therapy prediction and outcome of retreatment. AJNR Am J Neuroradiol 28:1755–1761

    Article  PubMed  CAS  Google Scholar 

  7. Sluzewski M, van Rooij WJ, Rinkel GJ, Wijnalda D (2003) Endovascular treatment of ruptured intracranial aneurysms with detachable coils: long-term clinical and serial angiographic results. Radiology 227:720–724

    Article  PubMed  Google Scholar 

  8. Sluzewski M, van Rooij WJ, Beute GN, Nijssen PC (2005) Late rebleeding of ruptured intracranial aneurysms treated with detachable coils. AJNR Am J Neuroradiol 26:2542–2549

    PubMed  Google Scholar 

  9. Holmin S, Krings T, Ozanne A, Alt JP, Claes A, Zhao W, Alvarez H, Rodesch G, Lasjaunias P (2008) Intradural saccular aneurysms treated by Guglielmi detachable bare coils at a single institution between 1993 and 2005: clinical long-term follow-up for a total of 1810 patient-years in relation to morphological treatments results. Stroke 39:2288–2297

    Article  PubMed  Google Scholar 

  10. Ferns SP, Sprengers MES, van Rooij WJ, Rinkel GJE, van Rijn JC, Bipat S, Sluzewski M, Majoie CBLM (2009) Coiling of intracranial aneurysms: a systematic review on initial occlusion and reopening and retreatment rates. Stroke 40:e523–e529

    Article  PubMed  Google Scholar 

  11. Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) Group (2011) Determinants of poor outcome following aneurysmal subarachnoid hemorrhage when both clipping and coiling are available: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan. World Neurosurg (in press)

  12. Drake CG (1988) Report of World Federation of Neurological Surgeons Committee on a universal subarachnoid hemorrhage grading scale. J Neurosurg 68:985–986, Letter

    Google Scholar 

  13. Fisher CM, Kistler JP, Davis JM (1980) Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computerized tomographic scanning. Neurosurgery 6:1–9

    Article  PubMed  CAS  Google Scholar 

  14. Lyden PD, Lau GT (1991) A critical appraisal of stroke evaluation and rating scales. Stroke 22:1345–1352

    Article  PubMed  CAS  Google Scholar 

  15. Roy D, Milot G, Raymond J (2001) Endovascular treatment of unruptured aneurysms. Stroke 32:1998–2004

    Article  PubMed  CAS  Google Scholar 

  16. Raymond J, Roy D (1997) Safety and efficacy of endovascular treatment of acutely ruptured aneurysms. Neurosurgery 41:1235–1245

    Article  PubMed  CAS  Google Scholar 

  17. Murayama Y, Nien YL, Duckwiler G, Gobin YP, Jahan R, Frazee J, Martin N, Vinuela F (2003) Guglielmi detachable coil embolization of cerebral aneurysms: 11 years’ experience. J Neurosurg 98:959–966

    Article  PubMed  Google Scholar 

  18. van Rooij WJ, Sprengers ME, Sluzewski M, Beute GN (2007) Intracranial aneurysms that repeatedly reopen over time after coiling: imaging characteristics and treatment outcome. Neuroradiology 49:343–349

    Article  PubMed  Google Scholar 

  19. Kang HS, Han MH, Kwon BJ, Kwon OK, Kim SH (2006) Repeat endovascular treatment in post-embolization recurrent intracranial aneurysms. Neurosurgery 58:60–70

    Article  PubMed  Google Scholar 

  20. Gallas S, Januel AC, Pasco A, Drouineau J, Gabrillargues J, Gaston A, Cognard C, Herbreteau D (2009) Long-term follow-up of 1036 cerebral aneurysms treated by bare coils: a multicentric cohort treated between 1998 and 2003. AJNR Am J Neuroradiol 30:1986–1992

    Article  PubMed  CAS  Google Scholar 

  21. Campi A, Ramzi N, Molyneux AJ, Summers PE, Kerr RS, Sneade M, Yarnold JA, Rischmiller J, Byrne JV (2007) Retreatment of ruptured cerebral aneurysms in patients randomized by coiling or clipping in the International Subarachnoid Aneurysm Trial (ISAT). Stroke 38:1538–1544

    Article  PubMed  Google Scholar 

  22. Thornton J, Debrun GM, Aletich VA, Bashir Q, Charbel FT, Ausman J (2002) Follow up angiography of intracranial aneurysms treated with endovascular placement of Guglielmi detachable coils. Neurosurgery 50:239–250

    PubMed  Google Scholar 

  23. Meyers PM, Schumacher HC, Higashida RT, Derdeyn CP, Nesbit GM, Sacks D, Wechsler LR, Bederson JB, Lavine SD, Rasmussen P (2009) Reporting standards for endovascular repair of saccular intracranial cerebral aneurysms. Stroke 40:e366–e379

    Article  PubMed  Google Scholar 

  24. Pierot L, Leclerc X, Bonafé A, Bracard S, Investigators French Matrix Registry (2008) Endovascular treatment of intracranial aneurysms with Matrix detachable coils: midterm anatomical follow-up from a prospective multicenter registry. AJNR Am J Neuroradiol 29:57–61

    Article  PubMed  CAS  Google Scholar 

  25. Pierot L, Cognard C, Ricolfi F, Anxionnat R, for the CLARITY Investigators (2010) Immediate anatomic results after the endovascular treatment of ruptured intracranial aneurysms: analysis in the CLARITY series. AJNR Am J Neuroradiol 31:907–911

    Article  PubMed  CAS  Google Scholar 

  26. Gallas S, Pasco A, Cottier JP, Gabrillargues J, Drouineau J, Cognard C, Herbreteau D (2005) A multicenter study of 705 ruptured intracranial aneurysms treated with Guglielmi detachable coils. AJNR Am J Neuroradiol 26:1723–1731

    PubMed  Google Scholar 

  27. Cognard C, Weill A, Spelle L, Piotin M, Castaings L, Rey A, Moret J (1999) Long term angiographic follow-up of 169 intracranial berry aneurysms occluded with detachable coils. Radiology 212:348–356

    PubMed  CAS  Google Scholar 

  28. Schaafsma JD, Sprengers ME, van Rooij WJ, Sluzewski M, Majoie CB, Wermer MJ, Rinkel GJ (2009) Long-term recurrent subarachnoid hemorrhage after adequate coiling versus clipping of ruptured intracranial aneurysms. Stroke 40:1758–1763

    Article  PubMed  Google Scholar 

  29. Bederson JB, Connolly ES Jr, Batjer HH, Dacey RG, Dion JE, Diringer MN, Duldner JE Jr, Harbaugh RE, Patel AB, Rosenwasser RH (2009) Guidelines for the management of aneurysmal subarachnoid hemorrhage: a statement for healthcare professionals from a special writing group of the Stroke Council, American Heart Association. Stroke 40:994–1025

    Article  PubMed  Google Scholar 

  30. Derdeyn CP, Graves VB, Turski PA, Masaryk AM, Strother CM (1997) MR angiography of saccular aneurysms after treatment with Guglielmi detachable coils: preliminary experience. AJNR Am J Neuroradiol 18:279–286

    PubMed  CAS  Google Scholar 

  31. Farb RI, Nag S, Scott JN, Willinsky RA, Marotta TR, Montanera WJ, Tomlinson G, Terbrugge KG (2005) Surveillance of intracranial aneurysms treated with detachable coils: a comparison of MRA techniques. Neuroradiology 47:507–515

    Article  PubMed  Google Scholar 

  32. Sprengers ME, Schaafsma J, van Rooij WJ, Sluzewski M, Rinkel GJ, Velthuis BK, van Rijn JC, Majoie CB (2008) Stability of intracranial aneurysms adequately occluded 6 months after coiling: a 3 T MR angiography multicenter long-term follow-up study. AJNR Am J Neuroradiol 29:1768–1774

    Article  PubMed  CAS  Google Scholar 

  33. Sluzewski M, van Rooij WJ, Slob MJ, Bescos JO, Slump CH, Wijnalda D (2004) Relation between aneurysm volume, packing, and compaction in145 cerebral aneurysms treated with coils. Radiology 231:653–658

    Article  PubMed  Google Scholar 

  34. Richling B, Gruber A, Bavinzski G, Killer M (1995) GDC-system embolization for brain aneurysms: location and follow-up. Acta Neurochir 134:177–183

    Article  CAS  Google Scholar 

Download references

Acknowledgment

This work was supported in part by a grant-in-aid from the Foundation for Biomedical Research and Innovation Translational Research Informatics Center.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan

    Waro Taki

Authors
  1. Waro Taki
    View author publications

    You can also search for this author in PubMed Google Scholar

Consortia

PRESAT group

Corresponding author

Correspondence to Waro Taki.

Additional information

PRESAT group members along with their affiliations are listed in the Appendix.

Appendix: PRESAT group in Japan

Appendix: PRESAT group in Japan

Writing Committee: Waro Taki (Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu), Nobuyuki Sakai (Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe), Hidenori Suzuki (Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu); Principal Investigator: Waro Taki (Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu); Vice-principal Investigator: Nobuyuki Sakai (Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe); Organizing and Protocol Committee: Akio Hyodo (Department of Neurosurgery, Ryukyu University Hospital, Naha), Shigeru Nemoto (Department of Endovascular Surgery, Jichi Medical University Hospital, Utsunomiya), Toshio Hyogo (Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo), Tomoaki Terada (Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama), Kouichi Satoh (Department of Neurosurgery, Tokushima Red Cross Hospital, Tokushima), Naoya Kuwayama (Department of Neurosurgery, Toyama University Hospital, Toyama), Shigeru Miyachi (Department of Neurosurgery, Nagoya University Hospital, Nagoya), Masaki Komiyama (Department of Neurosurgery, Osaka City General Hospital, Osaka), Masayuki Ezura (Department of Neurosurgery, Sendai Medical Center, Sendai), Yuichi Murayama (Department of Neurosurgery, Jikei University School of Medicine, Minato-ku), Hiroshi Sakaida (Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu), Masayuki Maeda (Department of Radiology, Mie University Graduate School of Medicine, Tsu), Hiroshi Nagai (Foundation for Biomedical Research and Innovation Translational Research Informatics Center, Kobe); Neuroimaging Review Committee: Kimihiko Kichikawa (Department of Radiology, Nara Medical University, Kashihara), Akihiro Uemura (Department of Radiology, St. Luke’s International Hospital, Chuo-ku), Yuji Numaguchi (Department of Radiology, St. Luke’s International Hospital, Chuo-ku), Suketaka Momoshima (Department of Diagnostic Radiology, Keio University School of Medicine, Shinjuku-ku), Sachio Kuribayashi (Department of Diagnostic Radiology, Keio University School of Medicine, Shinjuku-ku), Chiaki Sakai (Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe); Participating Centers and Investigators: Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo (Toshio Hyogo, Taketo Kataoka), Department of Endovascular Neurosurgery, International Medical Center of Saitama Medical University, Hidaka (Shoichiro Ishihara), Department of Neurosurgery, Chiba Emergency Medical Center, Chiba (Yorio Koguchi, Shigeki Kobayashi), Department of Neurosurgery, Graduate School of Medicine, Gifu University, Gifu (Yukiko Enomoto, Kiyofumi Yamada, Shinichi Yoshimura), Department of Neuroendovascular Therapy, Kohnan Hospital, Sendai (Yasushi Matsumoto), Department of Neurosurgery, Kurume University Hospital, Kurume (Masaru Hirohata), Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe (Nobuyuki Sakai, Hidemitsu Adachi, Yasushi Ueno, Takeharu Kunieda, Chiaki Sakai, Hiroshi Yamagami, Hirotoshi Imamura, Masaomi Koyanagi, Kenichi Todo, Shiro Yamamoto, Yoji Kuramoto), Department of Neurosurgery, National Hospital Organization Mito Medical Center, Ibaraki (Makoto Sonobe, Noriyuki Kato), Department of Neurological Surgery, Nihon University School of Medicine, Itabashi-ku (Teruyasu Hirayama, Tsuneo Kano), Department of Neurosurgery, Geriatrics Research Institute and Hospital, Maebashi (Isao Naito), Department of Neurosurgery, Tokushima University Hospital, Tokushima (Shunji Matsubara, Junichiro Satomi, Koichi Satoh), Department of Neurosurgery, Mie University Graduate School of Medicine, Tsu (Hidekazu Hamada, Naoki Toma, Fumio Asakura, Hidenori Suzuki, Hiroshi Sakaida, Satoshi Matsushima, Waro Taki), Department of Neurosurgery, Wakayama Rosai Hospital, Wakayama (Tomoaki Terada), Department of Neuroendovascular Therapy, Sagamihara Kyodo Hospital, Sagamihara (Tadashi Shibuya), Department of Neurosurgery, Juntendo University School of Medicine, Bunkyo-ku (Hidenori Oishi), Department of Neurosurgery, Tachikawa General Hospital, Nagaoka (Hiroshi Abe), Department of Neurosurgery, Kyorin University School of Medicine, Mitaka (Yoshifumi Konishi, Eishi Sato), Department of Neurosurgery, Hyogo Brain and Heart Center at Himeji, Himeji (Mitsugu Nakamura), Department of Neurosurgery, Kitazato University School of Medicine, Sagami (Akira Kurata), Department of Neurosurgery, Dokkyo Medicine University Koshigaya Hospital, Koshigaya (Katsumi Houya, Takanori Uchida, Akio Hyodo), Department of Neurosurgery, Kokura Memorial Hospital, Kitakyushu (Ichiro Nakahara, Toshio Higashi, Nozomi Murai, Yasushi Iwamuro, Yoshihiko Watanabe, Hideaki Nakagaki, Masahiro Takezawa, Daiki Murata), Department of Neurosurgery, Osaka City General Hospital, Osaka (Masaki Komiyama), Department of Neurosurgery, Jikei University School of Medicine, Minato-ku (Yuichi Murayama, Toshihiro Ishibashi, Takayuki Saguchi, Masaki Ebara, Hideki Arakawa, Koreaki Irie), Interventional Neuroradiology Center, Aizawa Hospital, Matsumoto (Hisashi Nagashima), Department of Neurosurgery, University of Toyama, Toyama (Naoya Kuwayama), Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama (Kenji Sugiu, Koji Tokunaga, Ayumi Nishida), Endovascular Neurosurgery, Jichi Medical University Hospital, Shimotsuke (Katsunori Nanba, Shigeru Nemoto), Department of Neurosurgery, Fukuoka University Chikushi Hospital, Chikushino (Masanori Tsutsumi, Kiyoshi Kazekawa), Department of Endovascular Neurosurgery, Toranomon Hospital, Minato-ku (Mikito Hayakawa, Yuji Matsumaru); Data Center and Statistical Analysis: Foundation for Biomedical Research and Innovation Translational Research Informatics Center, Kobe (Yoshihiro Matsubayashi, Tomomi Sakabayashi, Keiko Miyakoda, Wataru Oohashi, Masaki Sano, Emiko Uno, Makiko Toyooka, Kaori Kuronaka, Kazuro Sakamoto, Hiroshi Nagai, Masanori Fukushima).

Rights and permissions

Reprints and permissions

About this article

Cite this article

Taki, W., PRESAT group. Factors predicting retreatment and residual aneurysms at 1 year after endovascular coiling for ruptured cerebral aneurysms: Prospective Registry of Subarachnoid Aneurysms Treatment (PRESAT) in Japan. Neuroradiology 54, 597–606 (2012). https://doi.org/10.1007/s00234-011-0945-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00234-011-0945-0

Keywords

Search

Navigation