title: Recanalization and rupture after intracranial aneurysm treatment.
abstract: BACKGROUND
  Treatment of intracranial aneurysm (ICA) can sometimes require several procedures. The aim of this study was to analyze the risk of recanalization and rupture recurrence after ICA treatment by endovascular coiling (EVC) or surgical clipping (SC) on a very long follow-up.
  
  
  METHODS
  Clinical data of 373 consecutive patients treated in our group between January 1996 and December 2006 as well by EVC as by SC for ruptured (RIA) or unruptured intracranial aneurysm (UIA), were reviewed. Patients were followed-up at least to August 2009. First radiologic follow-up done six months after EVC and between three and five years after SC (median time: 5 years). All patients underwent a clinical follow-up after treatment, at least by telephonic communication (median time: 6 years).
  
  
  RESULTS
  Out of 197 patients with 198 RIAs, 82 (42%) patients underwent an endovascular treatment and 115 (58%) were allocated to surgical treatment. From a total of 176 patients with 229 UIAs, 66 (37.5%) patients were treated by 74 EVC; and 110 (62.5%) patients were treated with 124 surgical procedures. Fifteen recanalizations of coiled RIAs were detected and only one in the surgical group (27% vs. 2%; P= 0.0008). Of the 15 recanalizations in the EVC group, 6 (40%) were initially completely occluded. We observed two rebleedings, one in each group (1.4% for EVC; 1% for SC; P=0.8).
  
  
  CONCLUSIONS
  Our findings during the longest reported follow-up confirm a greater risk of recanalization for RIA treated by EVC without so far a significant difference in the rerupture risk.
authors.affiliation: Department of Neurosurgery, Saint-Luc Hospital, Catholic University of Louvain, Brussels, Belgium.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Costa
authors.affiliation: Department of Neurosurgery, Saint-Luc Hospital, Catholic University of Louvain, Brussels, Belgium.
authors.forename: Geraldo
authors.initials: G
authors.lastname: Vaz
authors.affiliation: Department of Neurosurgery, Saint-Luc Hospital, Catholic University of Louvain, Brussels, Belgium.
authors.forename: Patrice
authors.initials: P
authors.lastname: Finet
authors.affiliation: Department of Radiology, Saint-Luc Hospital, Catholic University of Louvain, Brussels, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Goffette
authors.affiliation: Department of Anesthesiology, Saint-Luc Hospital, Catholic University of Louvain, Brussels, Belgium.
authors.forename: Marie-Agnès
authors.initials: MA
authors.lastname: Docquier
authors.affiliation: Department of Neurosurgery, Saint-Luc Hospital, Catholic University of Louvain, Brussels, Belgium - Christian.raftopoulos@uclouvain.be.
authors.forename: Christian
authors.initials: C
authors.lastname: Raftopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017542:Aneurysm, Ruptured / Q000601:surgery*; D002533:Cerebral Angiography / Q000379:methods; D004621:Embolization, Therapeutic / Q000379:methods; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments; D016896:Treatment Outcome