Initial Raymond-Roy Occlusion Classification but not Packing Density Defines Risk for Recurrence after Aneurysm Coiling.
Aneurysm regrowth
Balloon-assisted coiling
Endovascular treatment
Intracranial aneurysm
Journal
Clinical neuroradiology
ISSN: 1869-1447
Titre abrégé: Clin Neuroradiol
Pays: Germany
ID NLM: 101526693
Informations de publication
Date de publication:
Jun 2021
Jun 2021
Historique:
received:
06
04
2020
accepted:
08
06
2020
pubmed:
3
7
2020
medline:
9
11
2021
entrez:
3
7
2020
Statut:
ppublish
Résumé
After coil embolization of intracranial aneurysms, it is currently not well understood whether the initial coil packing density or the type of aneurysm residual perfusion, depicted by the modified Raymond-Roy occlusion classification, primarily effects the rate of aneurysm recurrence. We hypothesized that these factors interact and only one remains an independent risk factor. In this single center retrospective study, 440 patients with intracranial ruptured and unruptured aneurysms between 2010 and 2017 were screened. A total of 267 patients treated with stand-alone coiling, with or without stent or balloon assistance were included (age 54.1 ± 12.2 years, sex 70.4% female). Flow diverter or Woven EndoBridge (WEB) device implantation were exclusion criteria. Using a binary logistic regression model, independent risk factors for aneurysm recurrence were postinterventional modified Raymond-Roy occlusion classification class (Odds ratio [OR] 1.747, 95% confidence interval [CI] 1.231-2.480) and aneurysm diameter (OR 1.145, CI 1.032-1.271). A trend towards a higher recurrence in ruptured aneurysms did not reach significance (OR 1.656, CI 0.863-3.179). Aneurysm localization, packing density, and neck width were not independently associated with aneurysm recurrence. Independent risk factors for aneurysm recurrence after coil embolization with and without stent or balloon assistance were aneurysm diameter and postinterventional grading within the modified Raymond-Roy occlusion classification. Packing density interacted with the latter and was not independently associated to recurrence.
Identifiants
pubmed: 32613253
doi: 10.1007/s00062-020-00926-x
pii: 10.1007/s00062-020-00926-x
pmc: PMC8211605
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
391-399Références
Molyneux AJ, Kerr RS, Yu LM, Clarke M, Sneade M, Yarnold JA, Sandercock P; International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. 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. 2005;366:809–17.
doi: 10.1016/S0140-6736(05)67214-5
Wiebers DO, Whisnant JP, Huston J 3rd, Meissner I, Brown RD Jr, Piepgras DG, Forbes GS, Thielen K, Nichols D, O’Fallon WM, Peacock J, Jaeger L, Kassell NF, Kongable-Beckman GL, Torner JC; International Study of Unruptured Intracranial Aneurysms Investigators. Unruptured intracranial aneurysms: natural history, clinical outcome, and risks of surgical and endovascular treatment. Lancet. 2003;362:103–10.
doi: 10.1016/S0140-6736(03)13860-3
Brilstra EH, Rinkel GJ, van der Graaf Y, van Rooij WJ, Algra A. Treatment of intracranial aneurysms by embolization with coils: a systematic review. Stroke. 1999;30:470–6.
doi: 10.1161/01.STR.30.2.470
Molyneux A, Kerr R, Stratton I, Sandercock P, Clarke M, Shrimpton J, Holman R; International Subarachnoid Aneurysm Trial (ISAT) Collaborative Group. International Subarachnoid Aneurysm Trial (ISAT) of neurosurgical clipping versus endovascular coiling in 2143 patients with ruptured intracranial aneurysms: a randomised trial. Lancet. 2002;360:1267–74.
doi: 10.1016/S0140-6736(02)11314-6
Molyneux AJ, Birks J, Clarke A, Sneade M, Kerr RS. The durability of endovascular coiling versus neurosurgical clipping of ruptured cerebral aneurysms: 18 year follow-up of the UK cohort of the International Subarachnoid Aneurysm Trial (ISAT). Lancet. 2015;385:691–7.
doi: 10.1016/S0140-6736(14)60975-2
Molyneux AJ, Kerr RS, Birks J, Ramzi N, Yarnold J, Sneade M, Rischmiller J; ISAT Collaborators. Risk of recurrent subarachnoid haemorrhage, death, or dependence and standardised mortality ratios after clipping or coiling of an intracranial aneurysm in the International Subarachnoid Aneurysm Trial (ISAT): long-term follow-up. Lancet Neurol. 2009;8:427–33.
doi: 10.1016/S1474-4422(09)70080-8
Byrne JV, Sohn MJ, Molyneux AJ, Chir B. Five-year experience in using coil embolization for ruptured intracranial aneurysms: outcomes and incidence of late rebleeding. J Neurosurg. 1999;90:656–63.
doi: 10.3171/jns.1999.90.4.0656
Sluzewski M, van Rooij WJ, Rinkel GJ, Wijnalda D. Endovascular treatment of ruptured intracranial aneurysms with detachable coils: long-term clinical and serial angiographic results. Radiology. 2003;227:720–4.
doi: 10.1148/radiol.2273020656
Sluzewski M, van Rooij WJ, Slob MJ, Bescos JO, Slump CH, Wijnalda D. Relation between aneurysm volume, packing, and compaction in 145 cerebral aneurysms treated with coils. Radiology. 2004;231:653–8.
doi: 10.1148/radiol.2313030460
Raymond J, Guilbert F, Weill A, Georganos SA, Juravsky L, Lambert A, Lamoureux J, Chagnon M, Roy D. Long-term angiographic recurrences after selective endovascular treatment of aneurysms with detachable coils. Stroke. 2003;34:1398–403.
doi: 10.1161/01.STR.0000073841.88563.E9
Murayama Y, Nien YL, Duckwiler G, Gobin YP, Jahan R, Frazee J, Martin N, Viñuela F. Guglielmi detachable coil embolization of cerebral aneurysms: 11 years’ experience. J Neurosurg. 2003;98:959-66.
doi: 10.3171/jns.2003.98.5.0959
Ferns SP, Sprengers ME, van Rooij WJ, Rinkel GJ, van Rijn JC, Bipat S, Sluzewski M, Majoie CB. Coiling of intracranial aneurysms: a systematic review on initial occlusion and reopening and retreatment rates. Stroke. 2009;40:e523–9.
doi: 10.1161/STROKEAHA.109.553099
Kawanabe Y, Sadato A, Taki W, Hashimoto N. Endovascular occlusion of intracranial aneurysms with Guglielmi detachable coils: correlation between coil packing density and coil compaction. Acta Neurochir (Wien). 2001;143:451-5.
doi: 10.1007/s007010170073
Tamatani S, Ito Y, Abe H, Koike T, Takeuchi S, Tanaka R. Evaluation of the stability of aneurysms after embolization using detachable coils: correlation between stability of aneurysms and embolized volume of aneurysms. AJNR Am J Neuroradiol. 2002;23:762–7.
pubmed: 12006273
pmcid: 7974729
Roy D, Milot G, Raymond J. Endovascular treatment of unruptured aneurysms. Stroke. 2001;32:1998–2004.
doi: 10.1161/hs0901.095600
Mascitelli JR, Moyle H, Oermann EK, Polykarpou MF, Patel AA, Doshi AH, Gologorsky Y, Bederson JB, Patel AB. An update to the Raymond-Roy Occlusion Classification of intracranial aneurysms treated with coil embolization. J Neurointervent Surg. 2015;7:496–502.
doi: 10.1136/neurintsurg-2014-011258
Stapleton CJ, Torok CM, Rabinov JD, Walcott BP, Mascitelli JR, Leslie-Mazwi TM, Hirsch JA, Yoo AJ, Ogilvy CS, Patel AB. Validation of the Modified Raymond-Roy classification for intracranial aneurysms treated with coil embolization. J Neurointervent Surg. 2016;8:927–33.
doi: 10.1136/neurintsurg-2015-012035
Woodward K, Forsberg DA. AngioSuite: an accurate method to calculate aneurysm volumes and packing densities. J Neurointerv Surg. 2013;5 Suppl 3:iii28-32.
doi: 10.1136/neurintsurg-2012-010317
Futchko J, Starr J, Lau D, Leach MR, Roark C, Pandey AS, Thompson BG. Influence of smoking on aneurysm recurrence after endovascular treatment of cerebrovascular aneurysms. J Neurosurg. 2018;128:992-8.
doi: 10.3171/2016.12.JNS161625
Gruber A, Killer M, Bavinzski G, Richling B. Clinical and angiographic results of endosaccular coiling treatment of giant and very large intracranial aneurysms: a 7-year, single-center experience. Neurosurgery. 1999;45:793–803; discussion 803‑4.
doi: 10.1097/00006123-199910000-00013
Cognard C, Weill A, Spelle L, Piotin M, Castaings L, Rey A, Moret J. Long-term angiographic follow-up of 169 intracranial berry aneurysms occluded with detachable coils. Radiology. 1999;212:348–56.
doi: 10.1148/radiology.212.2.r99jl47348
Plowman RS, Clarke A, Clarke M, Byrne JV. Sixteen-year single-surgeon experience with coil embolization for ruptured intracranial aneurysms: recurrence rates and incidence of late rebleeding. Clinical article. J Neurosurg. 2011;114:863-74.
doi: 10.3171/2010.6.JNS091058
Gallas S, Januel AC, Pasco A, Drouineau J, Gabrillargues J, Gaston A, Cognard C, Herbreteau D. Long-term follow-up of 1036 cerebral aneurysms treated by bare coils: a multicentric cohort treated between 1998 and 2003. AJNR Am J Neuroradiol. 2009;30:1986–92.
doi: 10.3174/ajnr.A1744
Henkes H, Fischer S, Mariushi W, Weber W, Liebig T, Miloslavski E, Brew S, Kühne D. Angiographic and clinical results in 316 coil-treated basilar artery bifurcation aneurysms. J Neurosurg. 2005;103:990–9.
doi: 10.3171/jns.2005.103.6.0990
Thornton J, Debrun GM, Aletich VA, Bashir Q, Charbel FT, Ausman J. Follow-up angiography of intracranial aneurysms treated with endovascular placement of Guglielmi detachable coils. Neurosurgery. 2002;50:239–49; discussion 249–50.
pubmed: 11844258
Fiorella D, Albuquerque FC, McDougall CG. Durability of aneurysm embolization with matrix detachable coils. Neurosurgery. 2006;58:51–9; discussion 51-9.
doi: 10.1227/01.NEU.0000194190.45595.9E
Uchiyama N, Kida S, Nomura M, Hasegawa M, Yamashima T, Yamashita J, Matsui O. Significance of volume embolization ratio as a predictor of recanalization on endovascular treatment of cerebral aneurysms with guglielmi detachable coils. Interv Neuroradiol. 2000;6(Suppl 1):59–63.
doi: 10.1177/15910199000060S106
Piotin M, Spelle L, Mounayer C, Salles-Rezende MT, Giansante-Abud D, Vanzin-Santos R, Moret J. Intracranial aneurysms: treatment with bare platinum coils—aneurysm packing, complex coils, and angiographic recurrence. Radiology. 2007;243:500–8.
doi: 10.1148/radiol.2431060006
Raymond J, Guilbert F, Weill A, Roy D. Follow-up of treated aneurysms: the challenge of recurrences and potential solutions. Neuroimaging Clin N Am. 2006;16:513–23.
doi: 10.1016/j.nic.2006.04.004
Johnston SC, Dowd CF, Higashida RT, Lawton MT, Duckwiler GR, Gress DR. Predictors of rehemorrhage after treatment of ruptured intracranial aneurysms: the Cerebral Aneurysm Rerupture After Treatment (CARAT) study. Stroke. 2008;39:120–5.
doi: 10.1161/STROKEAHA.107.495747
Ries T, Siemonsen S, Thomalla G, Grzyska U, Zeumer H, Fiehler J. Long-term follow-up of cerebral aneurysms after endovascular therapy prediction and outcome of retreatment. AJNR Am J Neuroradiol. 2007;28:1755–61.
doi: 10.3174/ajnr.A0649
Taussky P, Kallmes DF, Cloft H. Mathematic analysis of incremental packing density with detachable coils: does that last coil matter much? AJNR Am J Neuroradiol. 2012;33:E74–5.
doi: 10.3174/ajnr.A2454