title: Late reopening of adequately coiled intracranial aneurysms: frequency and risk factors in 400 patients with 440 aneurysms.
abstract: OBJECTIVE
  In aneurysms that are adequately occluded 6 months after coiling, the risk of late reopening is largely unknown. We assessed the occurrence of late aneurysm reopening and possible risk factors.
  
  
  METHODS
  From January 1995 to June 2005, 1808 intracranial aneurysms were coiled in 1675 patients at 7 medical centers. At 6 months, 1066 aneurysms in 971 patients were adequately occluded. At mean 6.0 years after coiling, of the 971 patients, 400 patients with 440 aneurysms underwent 3 Tesla magnetic resonance angiography to assess occlusion status of the aneurysms. Proportions and corresponding 95% CI of aneurysm reopening and retreatment were calculated. Risk factors for late reopening were assessed by univariate and multivariate logistic regression analysis, and included patient sex, rupture status of aneurysms, aneurysm size≥10 mm, and aneurysm location.
  
  
  RESULTS
  In 11 of 400 patients (2.8%; 95% CI, 1.4-4.9%) with 440 aneurysms (2.5%; 95% CI, 1.0-4.0%), late reopening had occurred; 3 reopened aneurysms were retreated (0.7%; 95% CI, 0.2-1.5%). Independent predictors for late reopening were aneurysm size≥10 mm (OR 4.7; 95% CI, 1.3-16.3) and location on basilar tip (OR 3.9; 95% CI, 1.1-14.6). There were no late reopenings in the 143 anterior cerebral artery aneurysms.
  
  
  CONCLUSIONS
  For the vast majority of adequately occluded intracranial aneurysms 6 months after coiling (those<10 mm and not located on basilar tip), prolonged imaging follow-up within the first 5 to 10 years after coiling does not seem beneficial in terms of detecting reopened aneurysms that need retreatment. Whether patients might benefit from screening beyond the 5- to 10-year interval is not yet clear.
authors: Department of Radiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands. S.P.Ferns@amc.uva.nl
authors: Sandra P
authors: SP
authors: Ferns
authors: Marieke E S
authors: ME
authors: Sprengers
authors: Willem Jan
authors: WJ
authors: van Rooij
authors: Wim H
authors: WH
authors: van Zwam
authors: Gérard A P
authors: GA
authors: de Kort
authors: Birgitta K
authors: BK
authors: Velthuis
authors: Joanna D
authors: JD
authors: Schaafsma
authors: René
authors: R
authors: van den Berg
authors: Menno
authors: M
authors: Sluzewski
authors: Patrick A
authors: PA
authors: Brouwer
authors: Gabriël J E
authors: GJ
authors: Rinkel
authors: Charles B L M
authors: CB
authors: Majoie
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D002532:Intracranial Aneurysm / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D016015:Logistic Models; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome