title: Predictors of residual flow in embolized intracranial ruptured aneurysms at early follow-up.
abstract: BACKGROUND
  The possibility of recanalization and the need for retreatment are the most important drawbacks of intracranial aneurysm embolization. The purpose of the study was to prospectively analyze the results of early follow-up angiography of embolized ruptured aneurysms in an attempt to determine factors predicting the presence of residual flow.
  
  
  METHODS
  Evaluation included 72 patients with 72 aneurysms, which were followed-up 3 months after the treatment. Analysis of residual flow predictors included: age and gender, clinical state in Hunt-Hess scale, aneurysm localization, aneurysm three dimensions and volume, neck width, sac-to-neck ratio, initial result of embolization, number of coils used and the use of hydrogel coils and stents.
  
  
  RESULTS
  Mean sac diameter was 6.5±3.9 mm, and mean neck width was 2.9±1.4 mm. Follow-up angiography presented residual flow in 26 aneurysms (36.1%): class 2 in 8 aneurysms (11.1%), and class 3 in 18 cases (25.0%). Stable aneurysm filling was observed in 45 cases (62.5%), progression of residual flow in 25 cases (34.7%), and regression in 2 cases (2.8%). According to ROC analysis independent predictors of residual flow were aneurysm neck diameter (AUC 0.857, 95% CI: 0.755-0.928, p<0.0001) and sac-to-neck ratio (AUC 0.817, 95% CI: 0.708-0.898, p<0.0001). Cut-off point of the ROC curve was established at 2.8 mm for neck diameter, and 1.73 for sac-to-neck ratio.
  
  
  CONCLUSIONS
  Aneurysm neck diameter and sac-to-neck ratio are independently related to the residual flow in embolized ruptured aneurysms at early follow-up.
authors.affiliation: Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Serafin
authors.affiliation: Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Strześniewski
authors.affiliation: Faculty of Health Sciences, Higher School of Humanities and Economics in Włocławek, Włocławek, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Beuth
keywords: Embolization; Follow-up Imaging; Intracranial Aneurysm; Therapeutic