Selective embolization of unruptured intracranial aneurysms is associated with low retreatment rate.
BACKGROUND
To report long-term imaging findings of 101 patients with 129 unruptured intracranial aneurysms (UIA) treated by embolization.


METHODS
A retrospective review of our prospectively maintained database identified all patients with an UIA treated by embolization with coils only and with a minimal 12-month imaging follow-up. The clinical charts, procedural data, and angiographic results were reviewed.


RESULTS
Between March 2004 and June 2009, 101 patients with 129 UIA were identified (71 women/30 men, mean age = 51.4 years). Ninety-four aneurysms (73%) were large (10-25 mm), and 35 (27%) were small (<10 mm). Aneurysms mean size was 10.7 mm (median, 9 mm; range 3-22 mm); 87 UIA (67.5%) had a small neck (<4 mm or neck/sac ratio < 0.7), and 42 (32.5%) had a wide neck (> or =4 mm or neck/sac ratio > or = 0.7). Selective coiling with bare/coated coils was performed in 125 cases and four cases, respectively. The balloon-assisted technique was used in 47 cases (36.4%). Only one patient experienced a symptomatic complication (thromboembolism) and kept a slight hemiparesis. Immediate results included 77 complete occlusions (59.7%), 45 neck remnants (34.9%), and 7 incomplete occlusions (5.4%). Mean imaging follow-up of 32 months showed 104 stable occlusions (80.6%), 12 further thrombosis (9.3%), 7 major recanalizations (5.4%), and 6 minor recanalizations (4.7%). Retreatment was required in seven wide-necked and/or large aneurysms including four treated with coated coils. No bleeding occurred during follow-up.


CONCLUSIONS
Selective embolization of UIA is associated with stable long-term anatomical results and low retreatment rate.
Bandeira
Alexandra
A
Department of Radiology, Neuroradiology Section, Erasme University Hospital, Brussels, Belgium.
Raphaeli
Guy
G
Balériaux
Danielle
D
Bruneau
Michael
M
De Witte
Olivier
O
Lubicz
Boris
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D016208:Databases, Factual; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000209:etiology; D011183:Postoperative Complications; D011446:Prospective Studies; D019233:Retreatment; D012189:Retrospective Studies; D013923:Thromboembolism / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult