title: Anatomical results, rebleeding and factors that affect the degree of occlusion in ruptured cerebral aneurysms after endovascular therapy.
abstract: OBJECTIVE
  To present a series of ruptured cerebral aneurysms in consecutive non-selected patients treated with endovascular therapy, analyzing the initial degree of occlusion, its anatomical evolution mid-term and the variables that could statistically affect them.
  
  
  METHODS
  251 aneurysms were first treated with coiling (embolization). 203 patients were followed up with conventional angiography for 6-8 months after the initial treatment and 182 were followed up with three-dimensional time of flight MR angiography at 18-24 months. Postoperative and mid-term anatomical results were evaluated anonymously and independently using the modified Montreal Scale.
  
  
  RESULTS
  The initial rate of complete occlusion was 70.9%, with rates of neck remnants and aneurysm remants of 18.3% and 10.7%, respectively. The recurrence rate was 13% after 6 months and 2% between 6 months and 2 years. The rate of retreatment was 11%. Statistically, the variables that were found to be related to the initial degree of occlusion were the use of a remodeling balloon technique (p=0.012), the size of the aneurysm neck (p=0.044) and the size of the aneurysm (p=0.004). The recanalization rate at mid-term depended on the size of the aneurysm. Although aneurysms with partial occlusion initially tended to evolve to a worse degree of closure than those with complete occlusion initially, the relationship was not statistically significant (p=0.110).
  
  
  CONCLUSIONS
  Embolized aneurysms can develop a worse degree of closure even when the initial occlusion is complete. The degree of occlusion depends directly on morphological factors and the use of balloon-assisted techniques. The recanalization rate at mid-term depends on the size of the aneurysm and probably on the density of the packing achieved with the initial treatment.
authors.affiliation: Department of Radiology-Interventional Neuroradiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Murias Quintana
authors.affiliation: Department of Radiology-Interventional Neuroradiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Gil Garcia
authors.affiliation: Department of Radiology-Interventional Neuroradiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Vega Valdés
authors.affiliation: Department of Neurosurgery, LSU Health Sciences Center, Shreveport, Louisiana, USA.
authors.forename: Hugo
authors.initials: H
authors.lastname: Cuellar
authors.affiliation: Department of Radiology-Interventional Neuroradiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Meilán Martínez
authors.affiliation: Department of Radiology-Interventional Neuroradiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Saiz Ayala
authors.affiliation: Department of Radiology-Interventional Neuroradiology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Serafin
authors.initials: S
authors.lastname: Costilla Garcia
authors.affiliation: Department of Critical Care, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Escudero Augusto
authors.affiliation: Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Julio Cesar
authors.initials: JC
authors.lastname: Gutierrez Morales
authors.affiliation: Department of Neurosurgery, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: López García
mesh_terms: D000368:Aged; D017542:Aneurysm, Ruptured / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D057510:Endovascular Procedures / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012008:Recurrence; D019233:Retreatment / Q000639:trends; D013345:Subarachnoid Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Aneurysm; MRI; Magnetic Resonance Angiography; Subarachnoid