title: Clinical and angiographic outcome in patients with completely occluded intracranial aneurysms by endovascular coiling: our experience.
abstract: OBJECTIVE
  There are limited data about the rate of recanalization following complete coil occlusion. Long term clinical and angiographic outcome of completely occluded intracranial aneurysms (IAs) by the endovascular approach are presented.
  
  
  METHODS
  Over the course of 4 years, patients with IAs which were completely occluded by coiling at our institution were reviewed. Clinical and angiographic data were analyzed. The patients were clinically assessed using the Glasgow Outcome Scale (GOS). Follow-up angiographic findings were categorized as: stable aneurysm with no recanalization, recanalization with a neck remnant and recanalization with a body remnant.
  
  
  RESULTS
  83 aneurysms were identified in 74 patients (15 men and 59 women, average age 52.4 years) with complete occlusion post intervention. Treatment by coiling only was used in 73 aneurysms while stent assisted coiling was used in 10 cases. At the last angiographic follow-up (mean 16.3 months), 20 of the 83 aneurysms demonstrated various degrees of recanalization of which five had neck remnants and 15 had body remnants. The recanalization rate was significantly higher in large aneurysms (57%) compared with small aneurysms (14%). Clinically, 65 of the 74 patients showed good recovery (GOS score 5), eight had moderate disability (GOS score 4) and one was severely disabled (GOS score 3).
  
  
  CONCLUSIONS
  Complete endovascular occlusion of IA is certainly effective in preventing aneurysmal bleeding. However, recanalization rate, despite being lower when compared with subtotal occlusion, remains an issue. Longer follow-up is required.
authors: Department of Neurological Surgery, Wayne State University and the Detroit Medical Center, Detroit, Michigan 48201, USA. axavier@med.wayne.edu
authors: Andrew R
authors: AR
authors: Xavier
authors: Abdelaal
authors: A
authors: Abdelbaky
authors: Mahmoud
authors: M
authors: Rayes
authors: Ambooj
authors: A
authors: Tiwari
authors: Sandra
authors: S
authors: Narayanan
mesh_terms: D002533:Cerebral Angiography / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D060205:Therapeutic Occlusion / Q000379:methods*; D016896:Treatment Outcome