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The relation between packing and reopening in coiled intracranial aneurysms: a prospective study

  • Interventional Neuroradiology
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Abstract

We evaluated prospectively the relation between packing and reopening in coiled intracranial aneurysms. Packing, defined as the ratio between the volume of inserted coils and volume of the aneurysm expressed as percentage, was calculated for 82 intracranial aneurysms treated with detachable coils. Aneurysm volume was assessed from 3D angiography. Reopening of the aneurysmal lumen at the 6-month follow-up angiography was dichotomized into present or absent. We assessed whether packing above 24% protected against reopening. Twenty-three of 82 aneurysms (28%) showed reopening. Reopening was caused by compaction in 20 aneurysms and by partial thrombosis, undetected at the time of initial treatment in three aneurysms. Three of 29 aneurysms (10%) with a packing of more than 24% showed reopening. These three aneurysms contained partially intraluminal thrombosis undetected at the time of treatment. We conclude that in coiled intracranial aneurysms packing above 24% protects against reopening by compaction in non-thrombosed aneurysms. Since intraluminal thrombosis may go undetected at the time of treatment, follow-up angiography is still warranted in aneurysms with packing densities greater than 24%.

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References

  1. Brilstra EH, Rinkel GJ, van der Graaf Y, van Rooij WJ, Algra A (1999) Treatment of intracranial aneurysms by embolization with coils: a systematic review. Stroke 30:470–476

    PubMed  Google Scholar 

  2. Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R (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  PubMed  Google Scholar 

  3. 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

    Google Scholar 

  4. Byrne JV, Sohn MJ, Molyneux AJ, Chir B (1999) Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. J Neurosurg 90:656–663

    PubMed  Google Scholar 

  5. Cognard C, Weill A, Castaings L, Rey A, Moret J (1998) Intracranial berry aneurysms: angiographic and clinical results after endovascular treatment. Radiology 206:499–510

    PubMed  Google Scholar 

  6. Sluzewski M, Menovsky T, van Rooij WJ, Wijnalda D (2003) Coiling of very large or giant intracranial aneurysms: long-term clinical and serial angiographic results. AJNR Am J Neuroradiol 24:257–262

    PubMed  Google Scholar 

  7. Sluzewski M, van Rooij WJ, Slob MJ, Oliván Bescós J, Slump CH, Wijnalda D (2004) The relation between aneurysm volume, packing and compaction in 145 coiled cerebral aneurysms. Radiology 231:653–658

    Google Scholar 

  8. Slob MJ, Sluzewski M, van Rooij WJ, Roks G, Rinkel GJ (2004) Additional coiling of previously coiled cerebral aneurysms: clinical and angiographic results. AJNR Am J Neuroradiol 25:1373–1376

    PubMed  Google Scholar 

  9. Majoie CB, Sprengers ME, van Rooij WJ, Lavini C, Sluzewski M, van Rijn JC, den Heeten GJ (2005) MR angiography at 3T versus digital subtraction angiography in the follow-up of intracranial aneurysms treated with detachable coils. AJNR Am J Neuroradiol 26:1349–1356

    PubMed  Google Scholar 

  10. Piotin M, Iijima A, Wada H, Moret J (2003) Increasing the packing of small aneurysms with complex-shaped coils: an in vitro study. AJNR Am J Neuroradiol 24:1446–1448

    Google Scholar 

  11. Cloft HJ, Kallmes DF (2004) Aneurysm packing with hydrocoil embolic system versus platinum coils: initial clinical experience. AJNR Am J Neuroradiol 25:60–62

    Google Scholar 

  12. Kawanabe Y, Sadato A, Taki W, Hashimoto N (2001) Endovascular occlusion of intracranial aneurysms with Guglielmi detachable coils: correlation between coil packing density and compaction. Acta Neurochir (Wien) 143:451–455

    Article  Google Scholar 

  13. Slob MJ, van Rooij WJ, Sluzewski M (2005) Coil thickness and packing of cerebral aneurysms: a comparative study of two types of coils. AJNR Am J Neuroradiol 26:901–903

    Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, St. Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, 5022, GC Tilburg, The Netherlands

    Marjan J. Slob, Menno Sluzewski & Willem Jan van Rooij

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  1. Marjan J. Slob
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  2. Menno Sluzewski
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  3. Willem Jan van Rooij
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Correspondence to Menno Sluzewski.

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Slob, M.J., Sluzewski, M. & van Rooij, W.J. The relation between packing and reopening in coiled intracranial aneurysms: a prospective study. Neuroradiology 47, 942–945 (2005). https://doi.org/10.1007/s00234-005-1446-9

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  • DOI: https://doi.org/10.1007/s00234-005-1446-9

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