Re-treatment of patients with embolized ruptured intracranial aneurysms.
BACKGROUND
Although one third of patients with intracranial aneurysms treated by GDC embolization manifest recanalization, a strategy for their subsequent treatment remains to be established. We evaluated the efficacy and safety of additional treatments performed after the first coil embolization.


METHODS
We treated 168 patients with acute ruptured intracranial aneurysms by GDC embolization, which was stopped when angiography confirmed complete obliteration. We recorded the type and number of all GDCs introduced for aneurysm occlusion and obtained follow-up cerebral angiograms at 6 months and 1 and 2 years postembolization. Patients with major coil compaction that had not disappeared at 2 years after the first embolization underwent re-treatment.


RESULTS
During the follow-up period, 18 (10.7%) of the 168 patients underwent additional therapy. In 16, we performed second (n = 14) or more than 2 repeated (n = 2) coil placement procedures for the same aneurysm. One patient died after the fourth coil embolization. Two patients underwent surgery; their aneurysms showed no change in the degree of occlusion on follow-up angiograms.


CONCLUSIONS
The additional treatment of previously coil-embolized aneurysms is safe, and the strategy of regular follow-ups is effective.
Kai
Yutaka
Y
Department of Neurosurgery, Graduate School of Medical, Sciences, Kumamoto University, Kumamoto 860-8556, Japan. ykai@kumamoto-u.ac.jp
Hamada
Jun-Ichiro
J
Morioka
Motohiro
M
Yano
Shigetoshi
S
Nakamura
Hideo
H
Makino
Keishi
K
Kuratsu
Jun-Ichi
J
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D004621:Embolization, Therapeutic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D016896:Treatment Outcome