Journal article
Cerebral Aneurysm Sac Growth as the Etiology of Recurrence After Successful Coil Embolization
Stroke (1970), Vol.43(3), pp.866-868
2012
DOI: 10.1161/STROKEAHA.111.637827
PMCID: PMC3472954
PMID: 22180247
Abstract
Background and purpose: Coil compaction is thought to be the main mechanism for recurrence in cerebral aneurysms with previously successful coil embolization. We hypothesize that sac growth may be equally or more important. The objective was to study the relative roles of coil compaction and sac growth as explanations for aneurysm recurrence requiring retreatment in a study population using quantitative 3D image processing methods.
Methods: From July 2009 to December 2010, 175 aneurysms were coiled at the University of Iowa hospitals and clinics. Eight aneurysms had major recurrence requiring retreatment (4.4-12.1 months between procedures; mean: 7.2 months). The 3D structures of the vessel and coil mass were reconstructed using rotational angiography data scanned before and after both initial coil embolization and retreatment. Changes in the sac and coil mass over time were visualized using model registration techniques and quantified using volume calculations.
Results: All 8 of the coiled aneurysms with major recurrence had significant aneurysm sac growth (15% to 102% increase in volume), independent of change in coil volume. Five aneurysms with major recurrence had sufficient data for assessment of coil compaction. The coil mass volume decreased in 1 aneurysm (12% compaction by volume), did not change significantly in 1 aneurysm (increased by 1%), and significantly increased in 3 aneurysms (8%, 21%, and 25%) between the first treatment and before the second treatment.
Conclusions: In this study population, aneurysm sac growth, not coil compaction, was the primary mechanism associated with recurrence after initial coil embolization.
Details
- Title: Subtitle
- Cerebral Aneurysm Sac Growth as the Etiology of Recurrence After Successful Coil Embolization
- Creators
- David M HASAN - Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, United StatesAlexander I NADAREYSHVILI - Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, IA, United StatesAnna L HOPPE - Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, IA, United StatesKelly B MAHANEY - Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, United StatesDavid K KUNG - Department of Neurosurgery, Carver College of Medicine, University of Iowa, Iowa City, IA, United StatesMadhavan L RAGHAVAN - Department of Biomedical Engineering, College of Engineering, University of Iowa, Iowa City, IA, United States
- Resource Type
- Journal article
- Publication Details
- Stroke (1970), Vol.43(3), pp.866-868
- Publisher
- Lippincott Williams & Wilkins; Hagerstown, MD
- DOI
- 10.1161/STROKEAHA.111.637827
- PMID
- 22180247
- PMCID
- PMC3472954
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 2012
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Neurosurgery; Otolaryngology
- Record Identifier
- 9984040378102771
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