title: Predisposing factors for recanalization of cerebral aneurysms after endovascular embolization: a multivariate study.
abstract: BACKGROUND
  The recanalization of cerebral aneurysms after endovascular embolization (coiling or stent-assisted coiling) has been a matter of concern.
  
  
  OBJECTIVE
  To systematically evaluate the predisposing factors for cerebral aneurysm recanalization using multidimensional analysis in a large patient cohort.
  
  
  METHODS
  In 238 patients with 283 aneurysms, patient baseline characteristics, aneurysm morphological characteristics, treatment-related factors, and changes in flow hemodynamics after endovascular treatment (coiling or stent-assisted coiling) were compared between the recanalization and non-recanalization groups. Multivariate logistic regression analysis was performed to determine independent risk factors correlated with recanalization.
  
  
  RESULTS
  16 aneurysms treated by coiling recanalized, with a recurrence rate of 18.6%, and 24 recanalized in the lesions treated by stent-assisted coiling, with a recanalization rate of 12.2%. Large aneurysms (>10 mm, p=0.002) and a follow-up interval >1 year (p=0.027) were shown to be statistically significant between the recanalization and non-recanalization groups. For flow hemodynamic changes, three parameters (velocity on the neck plane, wall shear stress on the neck wall, and wall shear stress on the whole aneurysm) showed a relatively lower amplitude of decrease after endovascular treatment in the recanalization group. Interestingly, the velocity on the neck plane and wall shear stress on the neck wall may be elevated after treatment. Specifically, the reduction ratio (RR) of velocity on the neck plane showed significant difference between the groups in the multivariate analysis (p=0.013), and was considered an independent risk factor for recanalization.
  
  
  CONCLUSIONS
  The aneurysm size, follow-up interval, and flow hemodynamic changes, especially the RR of velocity on the neck plane, have important roles in aneurysm recanalization.
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Qianqian
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
authors.forename: Linkai
authors.initials: L
authors.lastname: Jing
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Toshiba Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, New York, USA.|Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, New York, USA.
authors.forename: Nikhil
authors.initials: N
authors.lastname: Paliwal
authors.affiliation: Toshiba Stroke and Vascular Research Center, University at Buffalo, The State University of New York, Buffalo, New York, USA.|Department of Mechanical and Aerospace Engineering, University at Buffalo, The State University of New York, Buffalo, New York, USA.|Department of Neurosurgery, University at Buffalo, The State University of New York, Buffalo, New York, USA.
authors.forename: Hui
authors.initials: H
authors.lastname: Meng
authors.affiliation: Department of Neurosurgery, The First Affiliated Hospital, Nanchang University, Nanchang, Jiangxi Province, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Institute of Biomechanics, Department of Aeronautics and Astronautics, Fudan University, Shanghai, China.
authors.forename: Shengzhang
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xinjian
authors.initials: X
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome
keywords: Aneurysm; Blood Flow