title: Angiographic outcome of intracranial aneurysms with neck remnant following coil embolization.
abstract: BACKGROUND
  The degree of aneurysm occlusion following coil embolization has an impact on aneurysm recanalization.
  
  
  OBJECTIVE
  To explain the natural history of intracranial aneurysms with neck remnant, Raymond-Roy Occlusion Classification (RROC) class II.
  
  
  METHODS
  A single-center, retrospective study of 198 patients with 209 aneurysms treated with coil embolization that were initially either RROC class I or II. The angiographic outcomes at short- and long-term follow-up were compared as well as the complication/re-treatment rates. Atypical aneurysms and those that had been previously treated were excluded.
  
  
  RESULTS
  Ninety-nine class I aneurysms were compared with 110 class II aneurysms. There was no difference in recanalization rate between the groups (class I 3.3% vs class II 8.5%, p=0.478) at short-term follow-up (8.2 months) and at subsequent follow-ups (21.7 and 52.1 months). There was also no difference in re-treatment rates (class I 3.3% vs class II 8.5%, p=0.196) or complication rates (class I 9.1% vs class II 4.6%, p=0.12). There were no aneurysm ruptures after treatment in either group.
  
  
  CONCLUSIONS
  The angiographic outcome of aneurysms with neck remnant following coil embolization is similar to that of completely occluded aneurysms in that most remain stable and few recanalize. This understanding could potentially help the interventional neurosurgeon avoid complications such as coil herniation, vessel compromise, and stroke in selected cases. Further investigation with a larger patient population is warranted.
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Justin R
authors.initials: JR
authors.lastname: Mascitelli
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Eric K
authors.initials: EK
authors.lastname: Oermann
authors.affiliation: Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Reade A
authors.initials: RA
authors.lastname: De Leacy
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Henry
authors.initials: H
authors.lastname: Moyle
authors.affiliation: Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Aman B
authors.initials: AB
authors.lastname: Patel
mesh_terms: D000328:Adult; D002533:Cerebral Angiography / Q000639:trends*; D004621:Embolization, Therapeutic / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015607:Stents / Q000639:trends; D016896:Treatment Outcome