Angiographic results of wide-necked intracranial aneurysms treated with coil embolization : a single center experience.
OBJECTIVE
Endovascular treatment of wide-necked intracranial aneurysms is a challenge and the durability and the safety of these treated aneurysms remain unknown. The aim of this study was to evaluate the clinical and long-term angiographic results of wide-necked intracranial aneurysms treated with coil embolization.


METHODS
Between January 2002 and December 2012, 53 wide-necked aneurysms treated with coil embolization were selected. Forty were female, and 13 were male. Twenty eight (52.8%) were ruptured aneurysms, and 25 (47.2%) were unruptured aneurysms. The patents' medical and radiological records were reviewed retrospectively.


RESULTS
Of the 53 aneurysms, coiling alone was employed in 45 (84.9%) and stent-assisted coiling was done in 8 (15.1%). The initial angiographic results revealed Raymond class 1 (complete occlusion) in 30 (56.6%) cases, Raymond class 2 (residual neck) in 18 (34.0%) cases, and Raymond class 3 (residual sac) in 5 (9.4%) cases. The mean angiographic follow-up period was 37.9 months (12-120 months). At the last angiographies, Raymond class 1 was seen in 26 (49.1%) cases, Raymond class 2 in 16 (30.2%), and Raymond class 3 in 11 (20.8%). Angiographic recurrence occurred in 22 (41.5%) patients, with minor recurrence in 7 (13.2%) cases and major recurrence in 15 (28.3%). Retreatment was performed in 8 cases (15.1%). A suboptimal result on the initial angiography was a significant predictor of recurrence in this study (p=0.03).


CONCLUSIONS
The predictor of recurrence in wide-necked aneurysms is a suboptimal result on the initial angiography. Long-term angiographic follow-up is recommended in wide-necked aneurysms.
Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea.
Joon Ho
JH
Song
Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea.
In Bok
IB
Chang
Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea.
Jun Hyong
JH
Ahn
Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea.
Ji Hee
JH
Kim
Department of Neurosurgery, Hallym University Sacred Heart Hospital, College of Medicine, Hallym University, Anyang, Korea.
Jae Keun
JK
Oh
Department of Neurosurgery, Kangdong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
Byung Moon
BM
Cho
Cerebral angiography; Intracranial aneurysm; Recurrence